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Reality vs. Relativism

Here’s some news that I know will come as a terrible shock to longtime readers: no one knows how to make fat people permanently thin. Or even less fat.

Dieting doesn’t work in the long term and often makes you fatter. WLS can kill you, in addition to other unpleasant side effects, and as with diets, there’s a good chance you’ll eventually gain it all back. “Lifestyle changes” are diets, even if you don’t like that word. Nobody sets out to lose weight temporarily, then end up fatter than ever within a few years. But that’s what happens to nearly everyone who makes a “lifestyle change” (without developing an eating disorder), because our bodies just aren’t interested in cooperating with our desire to be thin.

Despite all the billions of dollars that have been put into trying to figure this one out, still, no one knows how to make fat people permanently thin.

But in the latest fatosphere kerfuffle, I’ve seen lots of comments that essentially say one of two things:

Not everyone who wants to lose weight wants to be thin! Not everyone’s doing it for vanity! People who have noble reasons for wanting to lose weight, or who only want to get less fat instead of thin shouldn’t be discouraged!

Fat acceptance activists never want to acknowledge that some people are so fat it really does compromise their health! Some people need to lose weight, and dieting/WLS is right for them!

No. It just doesn’t work that way.

We don’t know how to bring about permanent weight loss safely for people who’d like to drop “the last 10 lbs.” or for people who are so fat their quality of life actually is compromised by fat itself. That was the whole point of Mariellen’s post. (Well, maybe not the whole point, but a big one.) She’s dieted and dieted and dieted. She’s had WLS, and it failed. She is still fat, and the fat is one cause of her mobility issues. In her case — as opposed to that of an average fat person, for whom being fully mobile and active is entirely possible — losing weight might theoretically alleviate some of her physical problems. But unfortunately, there is still no proven, safe way to make her — or anyone else — permanently thinner.

It is not merely a political belief that fat people, no matter how fat or how encumbered by it, will most likely not benefit in the long term from trying to lose weight. It’s reality. When it comes to extremely fat people who are suffering physically, it’s a terribly sad reality. But it’s still what’s shown by every single study (not that there are many) that follows up with dieters 5 years later, and by reams of anecdotal evidence: restricting calories and increasing exercise will not make you permanently thin. As for WLS, it seems to make some people thinner longer than dieting will, but at what price? It kills people outright, and makes others’ quality of life so horrible they commit suicide. It causes devastating permanent side effects in many people, and many others gain the weight back anyway. It absolutely does not qualify as a safe or proven method for making fat people permanently thin.

As it stands now, there is simply no such thing.

So it doesn’t matter what anyone’s reasons are for wanting to lose weight. It doesn’t matter if there’s a strong argument to be made that losing weight really would decrease someone’s suffering. It doesn’t matter if someone only wants to get down to 300 lbs. from 400, or only wants to lose enough weight to take the pressure off her knees, or only wants to lose weight because he’s been told it will lower his cholesterol/blood pressure/blood sugar. No one knows how to make it happen permanently, without the risk of grievous harm.

That’s why I am anti-WLS and anti-dieting. Because the reality is, those are not useful solutions, and in many cases, they’re harmful — even deadly — solutions.

I don’t judge individuals who resort to those options, because A) we all have a right to determine what happens with our own bodies, and B) there are no real fucking solutions for extremely fat people who are suffering.

But there’s a big difference between saying, “Yeah, I understand why you’re doing this, all things considered, and I’ve got my fingers crossed for you,” and “It’s not right for me, but it might be right for YOU!” My refusal to judge people who diet or undergo WLS is not about relativism. It is, once again, about reality: when there are no good options, you take whatever seems to be the best of a poor lot. I can understand and respect that. I can support people who make the decision to try something known to fail, even known to kill, when they have no real fucking options to improve their quality of life.

But from a political standpoint, what we need to be working toward are more and better options for suffering fat people, not quieting those who say dieting and WLS are shitty fucking options no matter how good your reasons for wanting to lose weight. Those people — and I am absolutely one of them, if you hadn’t noticed — are just acknowledging what all the evidence tells us, not trying to burst anyone’s bubble or condemn people to lifelong pain because we want to keep everyone as fat as possible. If I could wave a magic wand and take 100 lbs. off Mariellen’s arthritic joints forever, I’d do it in a heartbeat. But I can’t. And no doctor or diet can, either.

What that means is, we need to stop thinking in terms of who “needs” to lose weight and start thinking in terms of helping fat people. As I just said over at Mariellen’s place, saying “Some people need to lose weight!” is like saying, “Paralyzed people need to walk!” Yeah, if you’re paralyzed, walking would probably improve your quality of life. And if your fat causes you chronic pain and mobility issues, losing weight would probably improve your quality of life. But in both cases, wishing for a particular outcome doesn’t make it so. And yet, in only one of those cases does the medical community acknowledge that a patient deserves to be treated as-is when the ideal theoretical outcome is clearly out of reach.

If the gazillions of dollars being poured into weight loss research ever turn up something that will really help suffering fat people lose weight permanently, without the risk of death or disability — and, importantly, if it turns out that losing weight really does help those people physically — I will get right behind that. I will plug that shit every chance I get. I will still advocate as strongly and loudly as possible for fat acceptance and Health at Every Size, because for most of us, being fat is not, in itself, a health problem. But if they ever come up with a way to make people like Heidi and Mariellen feel better via weight loss? You can bet your sweet, fat ass I will amend my position to “Yes, sometimes, for some people, weight loss IS the answer.”

Problem is, gazillions of dollars and decades of research haven’t turned up a safe, reliable method for permanent weight loss. With the methods we have right now, trying to lose weight is usually counterproductive at best and lethal at worst, with a whole continuum of yucky outcomes in between — and only a tiny handful of positive outcomes, ever. That is just not fucking good enough. If a given drug only worked for less than 10% of people who took it, and in the other 90+% it A) ultimately did the opposite of what it was supposed to do, B) caused long-term damage to people’s organs, and C) oh yeah, killed people, would that drug still be on the market? Fuck no. So why, given the astonishing failure rates and side effects of the only known weight loss methods today, do doctors keep prescribing weight loss as a goddamned cure-all for fat people?

THAT is a problem for fat acceptance activists to address. And that is why many of us say that pro-dieting and pro-WLS talk has no place in fat acceptance circles. It’s not because we think being thin is a crime, or that the desire to be thinner, for any number of reasons, is at all difficult to understand. It’s because the methods we currently have for losing weight DON’T FUCKING WORK, and yet both society in general and the medical community insist that we must keep trying those things again, again, again, again — and they will acknowledge neither our human dignity nor our legitimate health problems until somehow, someday, we make this thing that works for practically NO ONE work for us.

Since finding the fat acceptance movement and learning about Health at Every Size, Mariellen’s started doing some seated exercises and some yoga. She is trying to build strength and flexibility, trying to do something to feel better in her body the way it is, because after being failed time and again by dieting, WLS, and doctors, she knows that right now, permanent weight loss is simply not a fucking option. All she can do is work with the body she’s got.

Wouldn’t it be nice if her doctors felt the same way — if, you know, they’d made some suggestions about how to exercise with a fat body and limited mobility, instead of just telling her to have WLS again, after it failed spectacularly for her AND she lost her best friend to it? Wouldn’t it be nice if all our doctors recognized our bodies as our bodies, instead of refusing to treat us properly until we go out and get entirely different bodies? Wouldn’t it be nice if they looked for any other cause of various health problems besides fat, whenever they see fat people? And if they’re not going to recognize causes other than fat, and not going to stop insisting that weight loss is the ideal, wouldn’t it be nice if they acknowledged that none of the currently available methods for weight loss WORK in the long run, and until we have one that does, maybe we need to, you know, think outside the fucking box?

I think that would be awfully nice, myself. And I think that should be a major goal of the fat acceptance movement. And I also think we should absolutely embrace those who are stuck between a rock and a hard place trying to get decent medical care as fat people.

But that doesn’t mean dieting and WLS are “right for some people,” or that there’s a better chance of them working for people in desperate circumstances than there is for those who just want to lose weight for superficial reasons. What it means is, things suck for fat people trying to get decent health care right now, and especially for very fat people who are in pain. What it means is, a lot of people end up with their fat backs against the wall, and it would be an egregious failure of both compassion and reason to treat them as if they’re simply making a free choice between a good option and a bad one.

But dieting and WLS are still not good solutions for “some people.” They are lousy fucking solutions for everyone. They don’t work, and they hurt people. Period. This is not a “what’s right for my body may not be right for yours” thing. So few people experience the desired long-term outcome from dieting or WLS that recommending them to anyone, let alone acting as if there’s a single good reason to believe they should work for everyone, ought to be considered the height of irresponsibility among medical professionals.

And among fat acceptance activists, there should be no dissent on this point. There will be, and there always has been, but there shouldn’t be. Because if you believe that in the big picture, dieting and WLS do not bring about the long-term results they’re supposed to, and are far more likely to do harm than good — as you damn well should believe, if you’re a reasonable person who’s looked at the evidence — then there is no one for whom those things are a good option. There are people for whom they’re understandable options, people for whom they seem like the only viable options. But dieting and WLS don’t magically become good options just because someone has a really outstanding reason for wanting to lose weight. The failure rate doesn’t magically drop just because someone’s extremely fat. The terrible side effects don’t disappear because someone’s in pain. The risk of death isn’t diminished because someone can’t walk across a room.

Dieting and WLS are plain lousy options for everyone, and we should be outraged that they are still the first and often only solutions fat people are offered when they seek medical attention. Embracing people who have gone those routes for one reason or another does not have to mean affirming those options as “good” or “right,” ever. They’re just not. Even if they work, they’re still not “good” or “right” in the big picture. Given the near 100% likelihood of failure and the possibility of long-term damage and death associated with them, we cannot lose sight of this simple truth: these are terrible fucking options, and we deserve better.

AMEN. This is the issue I was trying to wrestle with and articulate and understand and remind myself of in my comment to vesta44’s post. It’s not like you haven’t made this point many times in the past for those who care to take it in, but it is so relevant to the WLS discussion that I really, really appreciate that you addressed it again and so specifically. It is a big help to my understanding of WHY it is so important for FA to oppose WLS and dieting (and it’s NOT because y’all hate WLS-ers or dieters or somehow think that “fatter is best” even when somebody is sick or immobilized–it’s just that they can’t change their weight safely and permanently–and I think this post makes that abundantly clear) and I’m sure it will be to others too.

Dieting and WLS are plain lousy options for everyone, and we should be outraged that they are still the first and often only solutions fat people are offered when they seek medical attention.

I couldn’t agree with you more. Obviously. That is why I read your blog. I’m a relative newbie in terms of reading (for a few months here now, and I don’t always read the comments threads), so I may be talking about things that have already been discussed over and over again, but I’ll say my piece anyhow.

While this is a fat acceptance blog and not a ‘what is wrong with the medical profession’ blog, don’t you think that part of the problem is the medical system in general? The fact that doctors do not have adequate time to actually assess what is wrong with a patient and everything is about the bottom line (profit and whatnot) and, too, that more and more, we seem to be pandering to pharmaceutical companies. It is always about the easy way out when it comes to health care, which is very sad if you do not have the means or the luck to find an amazing doctor who will actually listen to the patient as an individual and not as a fat person (or, insert other type of person here).

A few years ago, I went in to see a doctor for chest pain. Severe chest pain. After about three minutes of talking a nurse practitioner about any other symptoms and a quick glance at my vitals, it was decided that I have anxiety (no shit) and I was immediately given a prescription for paxil. No questions about whether or not I believed in taking medicine (I do not) or whether or not that was really the right thing for me. It was the matter of the NP flipping through a little booklet right in front of my face and deciding that that was the suitable drug for me. The appointment could not have lasted more than seven minutes, and that includes time for flipping through the little booklet of symptoms/drugs.

This was not good health care, in my opinion. I filled the prescription, but never took it and decided that I needed to speak with someone who would actually listen to me. I went in to the same clinic for a physical a few months later and I happened to luck into the most remarkable doctor who actually listened to me and didn’t say anything about the fact that I was “overweight” or that (at the time) I was smoking or make any comments about what I ate or my activity level. She listened to me and made me feel like a person instead of like a tick on a tally sheet of patients “cared for” that day. And, when I told her of my absolute conviction against taking prescription medicine for anything, she recommended me to a homeopathist for treatment for my anxiety and for me as a whole.

I have never looked back. I still go to a doctor once a year, but will not be treated by prescription drugs.

I’m totally getting off track here, but the point is that perhaps western medicine, as it is, is just too narrow-minded and driven by big business to actually care for a patient, whatever the issue may be. In the case of ‘fat’ – it’s the easy answer for the medical profession. And, WLS is the answer given in the little booklet of treatments. They don’t take the individual or the whole body into account.

I’m not sure where this fits into the FAM, but shouldn’t we all be advocating for our health? And maybe, if someone finds a remarkable doctor, they can pass the information along to a friend so that the friend can also be treated like a person and not just for ‘the fat’?

I fear, though, that no matter what kind of strides we all make as advocates of our bodies and our health, that with a system that is fucked and broken, we’ll never be able to make the kind of progress where individuals aren’t told that they need WLS or they won’t be treated. How are we supposed to deal with that?

(Sorry for the rambling and for anything that might be repetitive or might not be totally relevant.)

See, I never thought of “lifestyle change” as necessarily synonymous with “weight-loss dieting,” especially since mine have involved needing to stay away from certain ingredients. My ex-husband was gluten-intolerant, which meant our lifestyle-change diet had to be gluten-free. And now I’m on a low-salt lifestyle-change diet to help keep my BP low. Neither change had anything whatsoever to do with weight loss, but they sure affected the foods bought and eaten…

You know, now it makes sense to me why people were conflating MikeyT’s claims (which read to me as just another version of “sometimes you have to make bad choices”) with the not-appearing-in-this-film “everyone needs to get excited about everybody’s choice to lose weight” viewpoint. I can see much more easily how “we should support people making this choice when they are in pain/when don’t want to get skinny/when they have a VERY GOOD REASON” is analogous to the latter viewpoint. I wasn’t really making the distinction at all between that and “we should be understanding that sometimes people make shitty choices when there are no good choices” — I mean, obviously I was only saying the latter, because I’m anti-WLS in all cases, but I wasn’t consciously or verbally distinguishing. But of course it makes perfect sense. And makes the whole dust-up seem a little less like a manufactured conflict.

I’m not sure where this fits into the FAM, but shouldn’t we all be advocating for our health? And maybe, if someone finds a remarkable doctor, they can pass the information along to a friend so that the friend can also be treated like a person and not just for ‘the fat’?

And Elayne, I hear what you’re saying, but I was talking specifically about the people who say, “Dieting doesn’t work — you have to make a lifestyle change if you want to keep the weight off!” Once upon a time, I was one of them. And most of those people? Are fat again 5 years later.

Yeah, lifestyle change can mean something innocuous but it is almost always code for “diet” in these days of disordered thinking. Not only dishonest/harmful because it is how everyone, including the medical community, has rhetorically gotten around the fact that diets don’t work… but also a huge pet peeve of mine. Just say you’re (not you, Elayne, I’m addressing whatever sanctimonious dieter is talking to me at the time :P) on a fucking diet because that’s what it is.

FJ, I also think that Mikey’s position (which I think is pretty moderate and understandable, all things considered, so I’m not trying to single him out here) also gives a little more credence to WLS’s efficacy than most here would. So to him it may have been like “WLS is risky but it does work, so desperate times call for desperate measures.” The argument there may have been one of just how effective/ineffective WLS is assumed to be.

I just got off the phone with very good childhood friend who I haven’t spoken to in about 2 years. She, like me, has struggled with her weight since childhood.

I told her that diets don’t work. Several times. While she told me about the new diet she was starting. Sigh.

I couldn’t go into detail at the time, but I’d planned to give her the whole HAES argument when we got together in the next few weeks. Then I popped over to this blog to find…Ding-ding-ding!…this perfectly-timed post.

Kate, I just fill thick. I have read your posts here and at Shakesville for months. I have even been thinking I am more or less a part of the FA movement. But, I read this cogent piece of yours and felt I’d only now stumbled upon the basics. Thank you for this eloquence of yours.

I have to be honest. I totally agree with everything you’ve said here, but I also have to honestly say that my thinking has only been changed recently.

And by recently, I mean within the last few weeks.

Through reading and comparing what I’ve read to what I know has happened to both myself and people I know, I’ve come to the realization that I’ve been…. well…. brainwashed is the best word I can come up with. I’ve been told my entire life that the only way I’m going to be healthy (not to mention acceptable) is to lose weight. Nobody ever took into account the fact that I have near-perfect blood pressure. I’ve never been hospitalized for anything other than childbirth. I’ve never even gone to the doctor for anything more serious than an infection (not counting my depression, but I think that falls into a totally different realm of “health”). But no, because I’m fat, I MUST be unhealthy. And I’ve believed it.

And I’m not alone, am I? We’ve (and by “we” I mean western society in general) been so indoctrined to believe that fat always equals unhealthy that we believe it without question. And diets and WLS sound like the magic cure-all, while the reality is so much different.

I think the problem is that the majority of us only know what “the man” wants us to know (to hijack an old phrase). Many people are so opposed to the idea that diets and WLS are bad because they’ve only been told one thing, and not the rest of it. It’s kind of like me saying “Oh, I’m black,” simply because there was one black ancestor on my mother’s side of the family. In reality, I’m so white I practically glow in the dark. But saying that wouldn’t “technically” be a lie. And that’s the position that a lot of the media, doctors, and certain organizations seem to have taken. They’re not “really” lying, so it’s okay, right?

Wrong.

And while I can’t claim to be an expert on anything other than myself, I think that with more education on the subject, more people will come to realize that what we’ve been led to believe is wrong. I don’t think it’s going to happen anytime soon, but I hope it does happen. Because then people won’t be pressured into doing something that’s ultimately harmful to them, and maybe – just maybe – we’ll start getting the help we really do need.

(I apologize if I’m not making much sense, but my brain seems to have been in a “fog” all day, and I’m doing the best I can. :) )

Kate, thank you so much for this. I feel like you said exactly what was in my brain but was clearly having difficulty finding its way out.

Erin – I totally agree with you, and I think there are certainly places where FA overlaps with things like feminism and getting the “industry” out of the health care industry. IMHO, there are plenty of places where FA would have natural allies with other important social movements. The problem, I suppose, is in whether they’re willing to “hang out with us,” y’know?

god, if MIKE HUCKABEE is the shining example of How We Can All Lose Weight, Keep It Off, and Run Marathons, the pro-diet argument is in SAD, SAD SHAPE.

Dude, a lot of people lose weight and “keep it off” for like a year or something. That does not actually qualify as “keeping it off.” Reminds me of that magazine cover that said “How they keep it off” regarding Kirstie Alley and Valerie Bertinelli, and I don’t believe either one of them had actually even “finished” losing weight (e.g. gotten to their “goal”) yet. A bit early to be bestowing weight-maintenance wisdom on the masses.

Or then there was that dude on the comment threads who said “people just lose too fast” (it has to be a lifestyle change, don’t you know), and when informed that the study he was questioning actually involved dieters losing a “safe, sensible” 1/2 to 2 lbs/week, moved the goalposts and said that ACTUALLY, they should only be losing like 5 pounds a year and THEN it would work. Never mind that there is no scientific evidence whatsoever for such a thing. People just can’t stand learning that keeping weight off is basically impossible, “lifestyle change” or not.

Agreed about the distinction between diet and lifestyle change.If it’s something that’s not easily maintainable, that feels like work, that you look at and don’t want to do for the rest of your life, it’s not a lifestyle change. (okay, well sometimes you don’t WANT to stop eating gluten or sugar or dairy or peanuts but there’s something else that forces you to change forever)

I think there are legitimate long-term changes, like a change in eating habits due to illness or allergy. Or getting a stove and being able to cook as opposed to living in the dorms. Or finding an activity you enjoy doing because it is fun and would do even if it didn’t change your weight one bit.

But even those things can start the disordered-eating feedback loop. Hell, they did for me. It wasn’t the changes themselves that were issues and it’s been a hell of a time separating my joy at being able to run without keeling over or being off a medication or learning to read my hunger from the importance weight took on.

Disordered-eating feedback loop aside, is it possible these things can cause permanent weight loss? To a very small degree. I think it’s like with HAES. Some people move back down to a lower point in their set-point range. However, in a society where people would rather starve themselves than accept themselves, that’s not really the answer people are looking for.

And in the small percentage of people we’ve been discussing where size itself becomes a factor? Yeah, there’s got to be something else going on. Something that we’re not finding because we’re so focused on the superficialities. Something tells me that forcing years of dieting on people only makes things worse.

I’m baffled as to why Heidi was given a guest post to write about something she was doing that you consider a terrible, stupid, deluded and possibly suicidal move on her part.

Heidi wants to lose weight. Plain and simple. She was unequivicol about that point in her post. She doesn’t feel either happy or healthy at 530 lbs. She never said “I wish I could stay this weight and just get the help I need for my various health problems. I have to do this because it’s the only way the doctors will take me seriously.” No, she said she wanted to lose weight.

Your contention that her desire to lose weight will not only do her no good at all, but will probably leave her much worse off doesn’t help Heidi in any way. As much as I respect your right to hold strong to whatever positions you have, and I know that you’re passionate on this topic, there’s a real human being getting caught in the middle of this, and she left herself very, very vulnerable in telling her story. When a person puts themself out there to be judged the way she did they need real support. I don’t feel that it’s truly supportive of Heidi to tell your readers that whatever her motives, be it vanity or health , her decision to get the surgery was the product of a tragic delusion that any fat person unwilling be happy with every last pound of their body will fall victim to. This is a moment where some are saying that she should now be forever banned from the movement. I know you’re not saying that, but all of this discussion about her personal choice leaves her in a humiliating position. Now she can either say “The surgery was a success, I feel better.” and get the response of “Liar!” or “Yeah, sure, wait until you fall apart. Then you’ll be sorry.” Or she can say “The surgery left me sicker than I was before I had it.” and she can get the response of “Told you so!” But she’s a real person with a real body, and she’s not just some political football to bounce around to make a point. Even if the point is totally correct and righteous.

If this post gets me banned from your blog for good, so be it. I want to be able to work with people even with disagreements because it’s very hard to get two people, let alone masses of people to agree on pretty much anything ever. As you know, I’m an great admirer of your writing and most of your political perspectives. And once again, I totally support your right to be against weight loss of any kind under any circumstances. I just don’t think you should have used Heidi’s story to make that point. This all made me very sad, and I’ll risk banning to say that. But I should add that even if I’m banned I’ll probably lurk around these parts anyway ’cause that’s just the way I am (-;

And in the small percentage of people we’ve been discussing where size itself becomes a factor? Yeah, there’s got to be something else going on. Something that we’re not finding because we’re so focused on the superficialities. Something tells me that forcing years of dieting on people only makes things worse.

YES. I don’t see how it could be otherwise. You don’t get to 500 lbs. just by eating “too many Big Macs” or something. This is a very important point.

Rose, I’m not going to ban you, but I’m baffled as to why you still don’t understand the distinction I’m making.

I understand that Heidi wants to lose weight. There is absolutely nothing wrong with wanting to lose weight, especially in her situation.

The problem is, there is no known way to achieve safe, permanent weight loss. So it doesn’t matter how bad you want it, you are unlikely to get it. And you might suffer a whole lot of problems in the trying.

That is true for everyone from Heidi to Oprah to Britney to me and you.

Heidi’s in a position where WLS seemed like her only shot at a better quality of life. I completely understand and support that, as I’ve said, oh, a billion times. And I really, really WANT her to be the exception to the rule, and for things to only get better for her from here.

That still doesn’t mean WLS was a “good” option for her. It means she only had incredibly crappy ones to choose from. It means she was shit out of both luck and better options when she decided to do it. And while I can’t speak for her, I think if you read her post again, you’ll see that that’s pretty much what she says, too.

Just curious – I don’t doubt that 95% of all diets fail, (when viewed in the medium to longt-term actual weight loss) but why is this so? It is because popular diets are pseudo-science, because of the (historically) high amounts of processed foods that are consumed in a ‘western’ diet, because the human body is not built to lose weight rapidly, etc? Or that dieting is dangerous because of unhealthy body images that are pushed in popular culture, and thus not worth the risk? I apologize if this is a very basic question.
It seems to me that the ideal in our popular culture (particularly for women) is a late adolescent type of body, of someone who is in the minority body type in the first place. And because of the unprecedented power of such ‘culture’ (because of the democratization of taste/leisure) the demand for the ‘obtaining’ such body type is very intense, while the means of obtaining it are suspect at best. Hence the fad diets, distorted body images, etc.
Right now I won’t venture anything on what options there might be to improve this present state, other than to posit that a rigorous, unbiased approach to assessing what really is an ‘unsafe’ weight for individuals (based entirely in customized criteria and nothing so crude as the BMI) would be welcome, as well as some kind of neutral cost/benefit analysis on if and how one can lose weight should it be medically indicated. But I fear that we are moving towards more of an arbitrary definition of a ‘desirable’ body type, and as people can increasingly pay someone to modify their bodies (whether with weight loss surgery, tattooing, or other as-yet unimagined and extreme modifications) the concept of what it is to be ‘human’ and, not to stretch the point too far, the definitions of ‘normal’ human behavior generally may become less organic. And I’m simply not convinced that this post-human aspiration is ultimately compatible with the longterm survival of our species.

David, there are a whole host of reasons why diets don’t work – and they are almost as varied as the people who diet. Most of them don’t work simply because it is incredibly, incredibly difficult to force the body to gain or lose large amounts of weight. Even if you stick to your limited food intake, eventually your body adjusts and you gain weight again. In fact, most people who diet wind up heavier because they are messing with their metabolic rate.

David, have you read the link at the top: “Don’t you realise fat is unhealthy?” It may answer some of your questions. Many of us in fat acceptance believe that the reason diets fail is because our body has a certain set point weight that it doesn’t like to move from. If you cut calories, your metabolism will just slow down to compensate for the reduced calories, and after a certain point you’ll stop losing weight. That’s a phenomenon known by many dieters as plateauing, and when dieters hit a plateau, they just further cut calories, which further slows their metabolism, until their body can’t take the low calorie intake anymore and sends unignorable cravings for fat and sugar. At some point the person gives in and starts eating normally again… but in the meantime their metabolism is still lowered, so not only do they gain back the weight they lost, but they sometimes gain back more. Repeat, repeat, repeat, and you’ll may very well end up much fatter than where you started. (Man, I went back and forth between second and third person all over that comment, but I’m sure you can figure it out).

Lifestyle changes aren’t just diets. A lifestyle change would be if you go from eating three packs of oreos a day to, well, not. It works if you’ve never left your TV and then you take up swimming. I agree that too often ‘Lifestyle change’ is used as a gentler way of saying diet but not always. Sometimes, it’s just a much needed lifestyle change. I suppose I’m mostly bothered by the pessimistic tone of this. I get it and I understand it, but if that were the case then smokers would never quit smoking and eating disordered individuals would never recover.

As far as weight is concerned, I would say that lifestyle change would only work if it’s your lifestyle – and not your genes- making you fat. And I guess people know which one they are. I also think it has a great deal to do with how you feel as a fat person and whether you’re able to carry weight healthfully.

I’ll openly admit that I’m not fat. But I’m very size acceptance because I run 2 1/2 miles a day and strength train twice a week and have been since I was diagnosed with depression two years ago. (Better than med for me) I eat very healthy as well, and by those standards you’d think I’d be a size two, but I’m a size 8. I don’t think I’m made to be ‘thin’ and no way would I try to starve myself to fit into a size meant for someone other than me.

YES. I don’t see how it could be otherwise. You don’t get to 500 lbs. just by eating “too many Big Macs” or something. This is a very important point.

Amen, as well. I’m assuming Heidi didn’t have BED but that’s one of my biggest beefs with the medical community. Sure, some fat people binge every night on a zillion calories but I’ll go out on a limb and say that MOST don’t.

David, a lot of what you’re asking is beyond the scope of this post, and there are some answers to it elsewhere on the site, so I’ll just invite you to poke around more.

But as for this:Right now I won’t venture anything on what options there might be to improve this present state, other than to posit that a rigorous, unbiased approach to assessing what really is an ‘unsafe’ weight for individuals (based entirely in customized criteria and nothing so crude as the BMI) would be welcome, as well as some kind of neutral cost/benefit analysis on if and how one can lose weight should it be medically indicated.

I don’t think the first part is even necessary — if your fat is causing health problems, you’re at an “unsafe” weight. If it’s not, you’re not.

The problem is twofold A) a lot of health problems are automatically attributed to fat because people are too intellectually lazy/fatphobic/brainwashed to look for other causes, and B) even if fat IS the cause, there’s already ample evidence that the current methods for losing weight fail in the long term. You don’t need to do the studies — they’re done. In April, the results of a review of 31 previous long-term dieting studies were released, showing that 2/3 of dieters gained at least all of their original weight back, most of those would have been better off, health-wise, not dieting, and that dieting was a strong predictor of future weight gain.

2/3 isn’t 95%, obviously, but the article I linked to says nothing about where the other third ended up — and it would be foolish to assume the majority of them kept all or even most of the weight off. I’m just under 5 years out from my last diet, and about 5 lbs. lighter than I was when I started it. (I lost 45 lbs. on that one, so I’ve gained 40 back so far.) If I don’t gain 5 more lbs. in the next few months, then I’ll be in the category of those who didn’t gain it ALL back — in that one third. Sure doesn’t make me a success story, though. Especially when you consider that prior to that one, I lost 65 lbs. and gained 75 back.

So, the reality is, we don’t know how to make fat people permanently less fat, even if it really would help them. And no, we don’t know why for sure, but the resounding failure rate of diets (and personal experience of dieters) certainly suggests that the problem isn’t that we all just give up at some point and start stuffing ourselves with donuts 24/7. Which is the primary explanation “science” has offered us so far.

I suppose I’m mostly bothered by the pessimistic tone of this. I get it and I understand it, but if that were the case then smokers would never quit smoking and eating disordered individuals would never recover.

Lolly, the crucial point here is that (except for a small minority who really are suffering for reasons that can be directly attributed to their weight), there should be nothing pessimistic about the statement, “We don’t know how to make fat people thin.” Most fat people can be healthy and active and fulfilled while being fat (though of course not all are, just as not all thin people are). There is no reason why fat has to be seen as a burden, except that this society heaps shit on fat people. And the big-picture problem to fix there isn’t fatness.

Also, the type of “lifestyle change” you’re talking about would fall under the rubric of Health at Every Size, not dieting. Dieting is a deliberate attempt to lose weight. HAES is a deliberate attempt to improve one’s health by being active and eating a balanced, varied diet, which may or may not result in weight loss — and probably won’t, long-term. I have no problem with the concept of making positive changes to your lifestyle — what I have a problem with is people telling me that I gained the weight back because I just didn’t COMMIT — which is what many, many people mean when they talk about “lifestyle changes.”

I’m assuming Heidi didn’t have BED but that’s one of my biggest beefs with the medical community. Sure, some fat people binge every night on a zillion calories but I’ll go out on a limb and say that MOST don’t.

And if someone DOES have BED? It’s not out of laziness and lack of self-discipline. This is eating far, far past the point of fullness. Yes, we all overstuff ourselves at times (hell, the idea of a feasting holiday seems pretty old and universal), but to eat well beyond the point of pain on a regular basis? It is not fun and it is indicative of something seriously wrong with the hormones that regulate homeoestasis and/or something underlying that is far more serious and self-destructive than god-forbid not eating steamed chicken and broccoli for dinner.

god, if MIKE HUCKABEE is the shining example of How We Can All Lose Weight, Keep It Off, and Run Marathons, the pro-diet argument is in SAD, SAD SHAPE.

Yeah, give me millions of dollars of taxpayer money so I can take three hours a day to work out like a hamster in my own private gym, eat expensive proteins like Kobe beef and yellowtail at every meal, and maybe get a secret lap-band or two, and watch how skinny I get! GAAAAH.

As far as weight is concerned, I would say that lifestyle change would only work if it’s your lifestyle – and not your genes- making you fat. And I guess people know which one they are. I also think it has a great deal to do with how you feel as a fat person and whether you’re able to carry weight healthfully.

The point is that even in people with BED (and I am one of them) there is often a mixture of causes. My genes predetermine me to be at least somewhat fat. I am sure about that because I was “pudgy” as a kid before I started bingeing and because on my mum’s side of the family there is not a single person who is not somewhat fat and on my dad’s side people are mixed. The irony is that I – and I assume many other fat kids – actually started bingeing partially because of “weight-loss interventions” – which is another important argument against diets… they don’t only mess with your metabolic rate, they also cause you to develop unhealthy eating behaviors – or at least I strongly suspect that this is the case, and there are a number of studies who seem to support this notion. Let me add that I was – just as so many other fat people – the poster child of any diet I was ever put on or put myself on. Even today I am actually quite “good” at restricting my food intake to ridiculously low levels. The problem is that I have never learned to really listen to my body when it comes to hunger/ satiety cues – or better I unlearned it at a very, very early age. So basically I am (still) stuck in cycle of dieting and bingeing – I try my best to get out of it, but it is quite difficult to do so even if you know quite well what you “should” do in theory. (What really pisses me off though is that practically every medical professional I try to explain this to will not get that my phases of food restriction are a problem – after all, everything is great as long as I loose weight, right? But I guess that’s a different story.)
Oh, and I completely agree with Entangled – overeating is no fun and I really don’t get how people can think that eating while you feel sick has anything to do with “overindulgence”.

Kate, I’ve never suggested or thought that going through with risky surgery was a “good” option for Heidi or any other person. I don’t think it’s a good option, I think it was an understandable option. That’s not the same thing. If that’s how you feel, then we don’t particularly disagree.

I think where we are in disagreement is over whether it was a bad and/or wrong choice. If you feel that Heidi is almost certain to fail in weight loss, because there’s no proven safe, effective way for anyone to do so, it at least implies that you think her priorities were misplaced in pursuing weight loss as a health goal. That I think that Heidi’s weight is keeping her from enjoying a good quality of life is based on her own words. She made a choice to go through with this even though she’s well aware that there can be serious, and yes, even fatal consequences that could result from it. So I’m taking seriously what this means to her. And if it means that much to her, I’m not going to tell her she made a bad choice by pointing to the statistics. She’s not a statistic, she’s a person who made a very difficult life choice. Until I have lived in another person’s body I don’t understand or presume I can make decisions about its needs. I see no contradiction in supporting Heidi at this moment of her life and in vehmently opposing weight loss surgery and the pursuit of weight loss. This is a clearly a very unique situation.

I have no idea if the surgery will be a success in either small or big ways. I’m helpless to do anything for her but wish her the best. I know you also wish her the best, I never doubted that. I don’t know how my position became one of “pro-weight loss surgery” because as I’ve tried to make clear, I’m not. I also never said “some” fat people are really being hurt by their weight. I was only refering to Heidi and that’s because she moved me to tears with her account of not being able to live without pain and serious depression.

Respecting another person’s decision to take their own risks isn’t the same as making a sweeping statement about people who are really, really fat being in immediate need of weight loss. I agree with you that the medical establishment has miserably failed Heidi and so many other people of size. I wish that Heidi had better and saner options but if she truly feels she doesn’t I simply don’t want to pass any judgment on the choice.

And TR, I absoutely agree with you that the choice was the lesser of two evils. I totally support working on creating better options so that it doesn’t ever have to come to this again for anyone.

I’ve had BED for seventeen years. It’s only since June that I’ve had some kind of handle on it. And to be honest, it’s only since I’ve decided never to diet again that I’ve had a handle on it. I’ve lost twenty pounds since June and I have not dieted. But this isn’t about weight–it’s about stepping out of hell. If you’ve been there long enough, it’s not about the size of your body anymore–you just want to stop punishing yourself. I think the reasons for ED are varied, but my problem was I thought I wasn’t a worthy human being the weight I was. Now I finally see that my body and my self-worth are not intertwined. I am worthy now. Now matter what I weigh in the future–it does not matter–I am a WORTHY HUMAN BEING NOW.

Yesterday I watched a rerun of an Oprah that covered Michael Moore’s doco “Sicko”, during which an important question was asked: Does the child of a gas station worker have the same right to medical attention as the child of a CEO?

Well, just change that to “does someone who weighs 200lbs+ have the same right to medical attention as someone who weighs under 200lbs?” and we get a pretty clear view of what is really wrong with current attitudes in healthcare. I think Westerners all view medical care as a fundamental right, yet it is not distributed as such to children in the U.S., so what hope do larger people have of being treated with compassion and dedication? So much treatment starts with, “Well, we’ll see how you go with losing a bit of weight first”.

As long as there is an ‘acceptably-rationalized’ weight discrimination (epidemic!) filtering through the research/diagnosis/care branches of the medical profession, there are only ever going to be shitty options available. Teh Fat engenders a typical response of not being able to see the trees for the forest. But hey, you don’t have to go logging the whole lot just to find the one tree with termites.

That I think that Heidi’s weight is keeping her from enjoying a good quality of life is based on her own words. She made a choice to go through with this even though she’s well aware that there can be serious, and yes, even fatal consequences that could result from it. So I’m taking seriously what this means to her. And if it means that much to her, I’m not going to tell her she made a bad choice by pointing to the statistics.

Rose, we are in complete agreement about this, even if you refuse to see it.

I am not suggesting that her priorities were misplaced, or that her choice was the wrong one, under the circumstances. I have never suggested that. I have just said that WLS is always a shitty option, even if you’re at a point, as Heidi was, where it’s pretty much the only one. As in, it’s the kind of shitty option you TAKE, when you’re all out of others, but that still doesn’t make it a shiny, happy option.

I don’t know what else Heidi could have done, in her situation. I might very well have done the same thing. In any case, I think she did her homework and made an incredibly difficult decision, and I really fucking hope it works out well for her. I have not told her and would not tell her that she shouldn’t have done it; that’s where I differ from Kell and perhaps other radical fat acceptance types. And not for nuthin’ it’s why I called Kell out for being fucking hateful towards Heidi, which is where this round of this convo started. I think Heidi did exactly what she had to do, and I’ve told her so. And I will continue to tell her so, and continue to tell her that I hope everything gets better from here for her. I have never insulted Heidi’s intelligence or questioned her decision, much less questioned her right to make that decision for herself.

But we’re not just talking about Heidi here. We ARE talking about statistics, and about lots of people who aren’t in Heidi’s circumstances. We are talking about problems with health care and society that go way beyond one person. So I’d really appreciate it if you’d stop putting words in my mouth where Heidi’s concerned.

Rose, I really don’t see what the disagreement is here — your last comment sounded to me like almost exactly the same thing that Kate has said many times. Maybe you’re picking up something from the tone of her posts that’s implying a condemnation of Heidi’s decision (?), but I know that’s not what Kate has been trying to say.

Kate and sweetmachine, at this point I don’t really see any disagreement. I’m sorry you thought I put words in your mouth, I think the issue of Heidi and issue of the statistics that prove weight loss isn’t sustainable got conflated in some way so if I read it wrong, I am sorry.

I felt words were being put in my mouth about my feelings on weight loss surgery, I never thought it was a good, let alone a shiny, happy option.

But I’d really like to call at truce at this point, especially since I don’t see us at any real disagreement.

Tangential to what Pippa said:
A fair number of fat people already have health insurance. Their problem isn’t finding a way to pay for health care. What those folks need is a way to get the health care they *already paid for.* It’s a consumer affairs/fraud problem.

And if someone DOES have BED? It’s not out of laziness and lack of self-discipline.

Um, definitely not what I was trying to say so let me try again. BED, in my opinion, needs to be addressed regardless of weight. It’s a disorder that a ‘lifestyle change’ (as Kate clarified and I agree with after her explanation) that’s as serious as anorexia. And being size positive doesn’t mean someone shouldn’t take steps to address what is frankly a danger to one’s health.

Kate, TR, Sweetmachine, as I said before, I don’t really think there’s a disagreement. Especially not where Heidi is concerned. I was touched by Kate’s post saying Kell had crossed a line and I agreed 100%. I never thought any harm was wished on Heidi from anyone here. If anything I said somehow conveyed that, I really am sorry. I know that you’re all in her corner and rooting for her, I never doubted that.

I was aware before this post that Kate and many others are against pursuing weight loss as a goal because it’s not scientifically proven as feasible. Perhaps my single biggest political difference with this view is not that I disagree with it, but that I’m less inclined to oppose people taking on goals that aren’t likely to be feasible. I do agree wholeheartedly that young girls and women need to given a better choice than living an eating disoredered life until the day they die. That’s why I support fat acceptance, minor philosophical differences be damned!

My difference in this particular discussion had little to do with the content and everything to do with the timing. Since a good friend had just been through WLS I was a bit upset to see the topic being taken up at all right in the wake of it. I’m not saying it should never be discussed, I just wished a week had passed because Heidi’s surgery was hanging over it in an uncomfortable way for me. That’s what I was reacting to and I really am sorry that I offended any of you. Once again, I hope there can be a truce. Kate, I think you should know by now that I’m a big fan of your blog!

I get tired of the dividing line some people have for fat. “It’s ok to be all fat accepting until you reach X number of pounds then you are too fat and you should diet or have WLS , for your health”.

There can be no “line” in fat acceptance. All people deserve respect and proper medical care no matter what the scale says.

And for those who dare speak his name (hucka…) one person is anecdotal evidence and has nothing to do with this discussion. “I know this one guy who…” is not a provable scientific study or success story. It might take him a few years but he will gain the weight back.

Hell I have lost hundreds of pounds over the years. All it proves is that anyone can starve themselves & hyper exercise themselves to a lower weight. But in my case and 98% of other cases… the fat comes back with a vengeance. The other 2% are still hyper exercising and starving and calling it a “life style change”.

Ya know, when I talked to my nurse practitioner 10 years ago, when she recommended the WLS, I asked her if she couldn’t come up with some way for me to exercise that wouldn’t cause me severe back pain (and she knew walking did that to me) and all she would tell me was “Walk, even if it’s painful, even if you have to stop and rest, just keep walking.” And you know, if I could have found a place to walk that had benches every 100 feet or so where I could have stopped and sat until my back quit hurting, bet your ass I would have been walking. But I was on SSI at the time, lived in a town with a population of 2,000 and there was nothing like that available. Why she didn’t suggest yoga, I don’t know, but I do know that chair yoga for elderly people has been around for more than 10 years. I know those stretch bands I bought have been around for more than 10 years. She could have suggested all of those, and I would have done them, but because the diets she put me on didn’t work for long, I was non-compliant and needed to be mutilated so I would reach the goal she set for me (she thought 140 lbs for a 5′ 8″ woman was totally realistic, which meant I would have had to diet off 210 lbs). Even at my most fit, the least I weighed was 175 (and I wore a size 14, back in 1974, when I was 21). I think a 14 then was smaller than a 14 is now, at least it is in the patterns I have from back then.
So I guess she would consider me REALLY non-compliant now, since the WLS she recommended didn’t work (and she knows that, she suggested I have it re-done, I told her she was out of her fucking mind). And you know what the icing on the cake is in all of that? She was fat too. So you would think she would have understood, but no, I was fat and lazy and a liar. THAT’S what FA is fighting, those attitudes that we get not only from thin medical personnel, but the fat ones too. THAT’S why I’m anti-WLS/WLD, I know from personal experience it doesn’t work and causes a hell of a lot more harm than good. That is why I joined FA, and why I refuse to be run off by the trolls (and after all, I don’t know the trolls, the trolls don’t mean shit to me, so why should their bigotry and assinine commentary bother me?).
But I can still hope that everything goes well for Heidi, because there might be a few people (very damned few) for whom this works and doesn’t kill them or give them nasty complications to deal with for the rest of their lives (I’ve never met any of them, but maybe they exist somewhere). I would hope so, because I really don’t want to think that doctors are so fat-phobic that they are willing to kill a lot of fat people on the off chance that one or two of them will get thin and stay that way.

It’s all good, Rose. And I hear you on the timing — it is unfortunate, and I hope Heidi will accept my apology if I’ve poured salt in her wounds.

I don’t just want to say “Kell started it! Nyah!” because I could have ended it, at least around here, of course. And wanting to avoid this is, in fact, why I closed comments on my response to Kell. But it just became a much bigger conversation than that original dust-up, and there were a lot of arguments being thrown around that I really disagree with. So I posted, ’cause that’s what I do.

Thanks. Once I figured out that my worth had nothing to do with the size of my body, I informed my husband that I would never diet again. To be honest, I was surprised that he was relieved. He was glad that the insanity was coming to an end. He doesn’t believe in dieting either, and he works in the science/health field.

And about BED being a health danger, I certainly cannot disagree with that statement. BED and diabetes has not been a fun experience–though I do not blame my diabetes on my weight. I’ve never quite believed that–even tho’ I’m sure many in today’s climate/hysteria would disagree with me. I would like to see some more talk about BED, though. I think we have a lot to teach each other. I think if you have overcome an ED (any) you’ve hopefully learned some lessons about body acceptance. Even if the way there was hard and painful.

I’m on the fence about a lot of the politics in this post. I agree 100% that diets do not work as well as your stance on WLS. I feel though that it creates a sense of victimization for anyone who is fat and isn’t feeling healthy and energetic and wants a different experience. There is no empowerment nor personal responsibility for what we put in our mouths in that way of being. Regardless of my current weight or genetic traits I am 100% responsible for my health. Responsible for how much exercise I get, what I put in my mouth, how I maintain balance in my life, get enough sleep, etc.

I feel that the medical community has failed us in many ways beyond fat people. A doctor will almost always give you a pill or a surgery for whatever the symptom without ever determining the root. (what is CAUSING chronic heartburn? joint pain? my dads arthritis?) So my idea of options is personal responsibility.

My position is that lifestyle changes certainly are not diets. They’re usually made slowly and they are “drastic”. It’s not just eating broccoli now and then, but it’s phasing stuff like white sugar and adding in stuff that’s healthier. For example adding in local fresh fruits with breakfast, and phasing out dough nuts and cereal. Adding in vegetables and salad with whatever else there is for lunch. Most “diets” are surely crap, but I’d like to see the failure rate for people who transition onto a diet of WHOLE unprocessed fresh and quality foods. I would consider that only a “feel good diet.”

It’s a highly personal thing so I would not dare to suggest any one way of eating is right for everyone. I’m simply saying that I think most people would find a degree of improved well being by making empowered choices to improving their health.

It’s late and I’m rambling… bottom line is what I got from your post is that for people who want to lose weight because their health is suffering it sucks big time there aren’t any good options. While there may not be options for weight loss, there are always options for improved health.

It’s late and I’m rambling… bottom line is what I got from your post is that for people who want to lose weight because their health is suffering it sucks big time there aren’t any good options. While there may not be options for weight loss, there are always options for improved health.

Nobody here has expressed that this is not the case for most people as far as I can see – although I find the “always” a bit problematic since people can get in quite extreme situations that are beyond their control.
That’s also the problem I have with the idea of total self-responsibility. Yes, we are responsible for ourselves (and that’s great, because it is exactly that responsibility which makes us free). However, self-responsibility is never total or complete. I have had people telling me that others can only hurt me as long as I “decide to let them hurt me”. This is crap. I can often (not always) walk out on a person that tries to hurt me and I can isolate myself emotionally in order to not get hurt (which is often not very healthy in itself) – but some things do get through the armor.
The same is true for health – there are factors like genetics, environmental influences beyond individual control, limited resources, as well as simple bad luck – all things one cannot change. Granted, there are also a lot of factors that one can change if one chooses to do so, but to hark only on personal responsibility is problematic in my opinion (it often ends in blaming the victim).

Most “diets” are surely crap, but I’d like to see the failure rate for people who transition onto a diet of WHOLE unprocessed fresh and quality foods.

The problem with trying to eat healthy for weight loss is that most people who are overweight will not become thin or “normal” (BMI) by eating healthy. I changed my diet kinda like you suggested over two years ago (swapped waffles for fruit and vegan sausage, white grains for whole grains) and while I lost some weight, I’m still in the “overweight” BMI category, just like I was before (though I’m A LOT healthier). Very few people can lose a significant amount of weight just by eating healthier but not restricting calories, so even if most people don’t gain the weight back after that if they only lost 10 or 20 lbs that’s not exactly a weight-loss success story. Healthy eating should be promoted for it’s own sake (to everyone, not just fat people) but promoting it for weight loss just gives people unrealistic expectations, and encourages the assumptions that fat people don’t eat well.

Regardless of my current weight or genetic traits I am 100% responsible for my health.

Laura, I think I see what you’re getting at, but I think your language is not empowering at all. The term “responsibility” implies (IMO) a moral responsibility — and as we like to remind people around here, health is not a moral imperative. The idea that fat people are just not “taking responsibility” is, in fact, a justification for a lot of fatphobia.

I don’t think that’s what you meant in your post, though; my sense is that you’re thinking of some of the principles of HAES, which says you can be try to be healthy in whatever body you’re given. Sure, you can eat what is going to make you feel strong and energized, but that’s not going to be the same for each person. For you, that may mean whole, unprocessed foods — but it won’t mean that for everyone.

Anyway, I don’t think the binary here is victim/responsible person. The language of responsibility is misleading. Just to give you a simple example, I have an intestinal disorder, and I’ve felt less than healthy the last few months. Am I responsible for that? No fucking way. Can I try to figure out what food will trigger flare-ups and what won’t? Absolutely. But even when I do that, I still have good days and bad days no matter how I act. Everyone’s health is like that in some degree; to say that you’re 100% responsible for your own health is to create an impossible sense of obligation to your body. Take care of yourself, but realize that if something goes wrong it is not your fault.

I would like to see some more talk about BED, though. I think we have a lot to teach each other.

I also would like to see more talk about BED. However, I have brought up the topic in the past on fat acceptance blogs and I was disappointed about the kind of reactions/ lack of reactions I got. It is possible that I did not bring it up in the best way, or that I simply expected to much in the first place, but I got the impression that this is something people in the fat acceptance community do not really want to talk about.

In particular I got a lot of responses along the lines of that I should talk to my therapist about it or that I just should accept my body, etc. However, the problem with the first kind of comment is that a lot of therapists (I would say the majority of therapists) don’t fully get the problem themselves – a lot of programs for binge eaters are still focusing on weight loss and that is very, very counterproductive in my opinion. Plus, I would argue that even for people with BED the main problem is NOT the weight gain, but the constant psychological stress of body hate and a daily life that is dominated by food. On the other hand the problem with the latter kind of comment (i.e., that I should simply accept myself, listen to internal cues, etc.) is that I KNOW THAT ALREADY, in fact I have known it for years, but knowing something intellectually and putting it in practice are two very different things.

I sometimes get the feeling that people in the movement are uncomfortable to talk about eating disorders and binge eating because they don’t want to support the stereotype that fat people in general are all compulsive overeaters or binge eaters. But although they do not affect the majority of fat people, eating disorders are a reality for some fat people, and unfortunately from my experience it is very, very hard to get proper help for your eating disorder when you are fat – because most people will automatically assume that if you lose weight that solves your problem – which is among other things completely ignorant of the fact that some fat people with an eating disorder actually have all the symptoms of anorexia with the only difference that they are not “underweight” which is a necessity for the diagnosis. More important for my situation it ignores that even many binge eaters are actually caught in a cycle of bingeing and dieting/ overexercising/ etc. as well as that there are a lot of negative thoughts and emotions involved that have not suddenly disappeared just because you lost some weight.

Thanks, Kate. I appreciate your response and I totally understand where you’re coming from. I’m sorry I let my reactiveness get the better of me, and I wish I had articulated what I was upset about earlier than I did.

P. S. Off-topic, I kept getting knocked off your site about 10 minutes ago, now it’s fine! By “knocked out” I mean I’d click on this story and get the “Close or Debug Now!” message. That it suddenly started working again makes no sense to me whatsoever, but I thought it would be good to know in trying to fix the problem.

Laura, aside from what Sweetmachine said, I think a few issues are getting mixed up here.
1) There is no proven way of losing weight.
2) For most fat people ,their fat isn’t actually what’s causing any health problems they may have. Those people can take steps to improve their health (if they choose) without worrying about weight loss. (Health At Every SIze).
3) The rare person like Heidi, who has some health and mobility problems caused directly by her fat is in a shitty situation, because there is no good, effective way of getting rid of that fat. And if we lived in a society where doctors cared about fat people, maybe they could work with Heidi on finding a way for her to be healthy without losing weight, or maybe try to figure out if there’s some underlying cause of her weight and treat that. But we don’t live in that society, and so people like Heidi really don’t have any good options. Which is really shitty.

Perhaps my single biggest political difference with this view is not that I disagree with it, but that I’m less inclined to oppose people taking on goals that aren’t likely to be feasible. I do agree wholeheartedly that young girls and women need to given a better choice than living an eating disoredered life until the day they die.

Rose, I think you’re on to something here. At least, this is what I struggle with. I understand, and am learning, that dieting and forced weight loss are (in the long run), uneffective and often downright harmful. And yet, I have pretty strong feelings about body autonomy and an individual’s right to choose. What I am learning is that Fat Acceptance can support body autonomy, even if it does not have to affirm everyone’s choices. Not agreeing with an individual’s choice is not necessarily a condemnation of the person. But I think that it’s important that the anti-WLS position be clear and non-fuzzy – it’s opposed because it’s harmful and unsafe, and a lousy option.

you do such a good job of presenting the issue in terms of lack of research/understanding about how fat works (i’m slowly working through the gospel of food — can’t wait for the last chapter). when the med industry only knows “FAT BAD,” we are not likely to make real progress, and some who don’t/can’t accept that will continue to argue in favor of the shit that’s killing us the least…

i’m also surprised at your energy, tackling all this for so long… i kinda miss reading about clothes.

Queendom, I absolutely agree. People don’t seem to want to talk about BED. I went through a BED program back when I lived in MN, and they told me I should NOT be on a diet. I so was disordered in my thinking at the time I couldn’t hear that. I was so convinced that all my problems would be solved if I was skinny. It was so sad, and I was so full of self-hate. I guess I wanted to bring this stuff up because I don’t think we should just be focusing on what is wrong with the prejudice out there concerning fat people, and about how diets don’t work, etc. I know all that is true. I just turned 36 this month, and it took me this long to get it. Diets don’t work. And people can be real assholes, and fat bias is a real bitch. But what else? How many of us honestly still hate our bodies because we live in a society that tells us we are not good enough the way we are? How do we change our minds about ourselves?

My position is that lifestyle changes certainly are not diets. They’re usually made slowly and they are “drastic”. It’s not just eating broccoli now and then, but it’s phasing stuff like white sugar and adding in stuff that’s healthier. For example adding in local fresh fruits with breakfast, and phasing out dough nuts and cereal. Adding in vegetables and salad with whatever else there is for lunch. Most “diets” are surely crap, but I’d like to see the failure rate for people who transition onto a diet of WHOLE unprocessed fresh and quality foods. I would consider that only a “feel good diet.”

Failure rate? You mean, would we turn all fat people into thin people permanently if they all ate “perfectly” every minute of their lives?

Sure, it’s possible to make changes that make one feel and function better, especially over time. But not everyone is in a position to eat 100% organic, locally grown, sugar free, flour free, blah blah everything, always, for the rest of their lives. For one thing, you pretty much have to be affluent and/or be an organic farmer yourself. For another, you have to live someplace where “local fruit” and such were readily available. As I mentioned here before, there are huge huge huge problems with how things are distributed in this world, so huge that my mother, who lives in South Florida, cannot buy a Florida orange where she lives. And it’s not like she couldn’t afford one; it’s that they send them all out of state.

Besides, it’s very, very, very difficult for the average person to avoid all sugar and flour for the rest of their lives. You pretty much have to live your life like a recovering meth addict in order to avoid substances that are completely legal and ubiquitous. Those substances would have to be banned — as in, burn all the sugar, corn and wheat fields and make it a capital crime to grow those crops — if the government is truly bloody serious that two-thirds of us are desperately ill by our own hands and have no clue how to feed ourselves and don’t want one, and that these are drugs of abuse for two-thirds of the population.

I think the operative problem here is that many, many people have tried giving up refined sugar and white flour and switching to whole foods (I think South Beach in a general sense is sort of like this) and they don’t “stick to it” any better than any other type of dieter. I think there are a lot of factors that go into it, many of which Meowser described (the external factors that make switching to all whole unprocessed foods impractical) and then the fact that your body just doesn’t seem to want to maintain large weight losses and will start sending powerful mental signals that cause you to “go off” your diet, or eating plan, or whatever, until you gain the weight back. Or, also if you are doing it for weight loss (which I know you didn’t really recommend, but a lot of people are on the “eat fresh whole foods and lose weight” bandwagon), if you don’t lose then you are likely to decide there’s no point to your new way of eating if it doesn’t cause weight loss.

I just don’t really think there is any point healthwise to making drastic changes to one’s diet (other than those needed for an individual person’s health issues, of course), whether for HAES, weight loss, or weight loss disguised as HAES, which frankly I think is very common. “Phasing out” white sugar or non-organic produce or processed foods or anything else may sound innocuous but can be just as self-punishing as a diet. Certainly I think that self-care for a lot of people who can afford and get their hands on these foods will include emphasizing a lot of the types of foods you describe, the stuff that we traditionally think of as “healthy.” But it is easy to get really black-and-white, good vs. bad with those foods too and that can be very dangerous for people with any kind of disordered approach to eating.

Folks with BED, I totally understand where you are coming from. I have past/current issues with compulsive eating too and the way I have come to see it over time, most people in the fat acceptance movement are not out to invalidate your experience or minimize your pain. People in FA just prefer not to emphasize binge/compulsive eating as a big issue because most fat people are not binge/compulsive eaters, so it is not really a topic that can be addressed in depth under the umbrella of fat acceptance, and although it took me a while I have come to understand that I need to go elsewhere for compulsive eating-related community. I agree with you that that can leave one feeling rather out-of-place, however (since we are fat people too). It is a difficult issue and one that I feel calls for activism one way or the other (even if not in this sphere) because of the shameful examples you have posted as to how eating-disordered fat people are treated by the medical community.

People in FA just prefer not to emphasize binge/compulsive eating as a big issue because most fat people are not binge/compulsive eaters, so it is not really a topic that can be addressed in depth under the umbrella of fat acceptance, and although it took me a while I have come to understand that I need to go elsewhere for compulsive eating-related community.

I completely get WHY people in the movement don’t want to address binge/compulsive eating – but I do not agree that this means it should not be addressed. I think in some ways it is a similar issue to the dilemma of on the one hand not excluding people who actually do have health/ mobility issues due to their weight and on the other hand not wanting to further support the stereotype of the fat, immobile, sick person.

The point is that – at least in my experience – fat people with eating disorders don’t really have a lot of resources right now outside the movement either, because ED self-help communities are often not meeting their needs. A good example is the fact that many ED information websites do give some information on BED but compared to the information they give on anorexia and bulimia this information is quite limited. They often also make the wrong statement that people with BED never engage in behavior that is meant to compensate weigh gain (yeah, right), and they often use BED and “obesity” interchangeably – while most of them fortunately don’t do the same thing with anorexia and underweight.

I think one point that might help to address this issue in the movement without further strengthening the idea that all fat people are eating disordered and that this is somehow their fault is to hark on the point that a lot of people developed an ED because they dieted – and that this is also true for people with BED. Further, in my opinion it would be important and beneficial for the whole movement if we would educate society that people with BED might lose some weight in the process of overcoming their eating disorder but that hardly anybody will become “thin” (that is, if they are not thin to begin with).

The thing is that right now I sometimes feel that anorectics are at times more welcome to talk about their struggles in the movement than are fat people with an ED, particularly fat people with BED. Of course, there are at times misguided attacks on either naturally thin people or anorectics (which is sad in my eyes – thin people are not the enemy). But by many people anorectics are seen as fellow victims of weight obsession while this does not seem to be true to the same degree of people with BED. I might be a bit oversensitive in this respect, though…

Anyways, this is going far, far off topic. Sorry for hijacking the thread.

queendom, I didn’t mean to lecture you and I’m sorry if it came off that way… suffice it to say that I totally agree with all the points you made. It seems to be a constant balancing act as far as what a movement should focus on and it seems that the concerns of majority have to be it. But that does not mean that people with BED and anorexia aren’t also suffering and that there aren’t huge problems with how these disorders are addressed. Especially if you are fat, in which case you have very few places to turn for help. It is very problematic and I’m not sure what the answer is.

Julie….I totally agree with you. You are Worthy! You go girl! Nobody, including the media and society, has the right to make anyone feel bad about themselves due to their weight. Our weight does not define us in anyway. What does define us individually, is how we look at ourselves, how we perceive ourselves. Look inward, and really “see” who we are. We need to like, and yes even love, who we are to see our true potential.
We are worthy–worthy to be loved for who we are.

Kate..
I agree with a lot of what you wrote, especially about WLS and dieting. You made good, strong points.
There is only one thing that I ask please. Could we not use that awful cuss word that starts with an f?
People can make good strong points without using nasty language like that. :)

Saykim, BED stands for binge eating disorder which in turn is an eating disorder that is similar to bulimia in that people affected eat large (very large) amounts of food in a very short period of time without engaging in purging behavior. (Let me add that just as the line between bulimia and anorexia is not clear cut in many cases since quite a few anorectics also engage in binge-eating and purging at times the line between binge-eating disorder and bulimia is not that clear cut either – binge eaters might not purge by throwing up for instance, but I for one have certainly tried a few times in the past and most binge eaters that I know have been on fasts/ diets many times in their lives.)

Kate,
You blog has been thought provoking and confronting to me as a fitness professional, fitness motivator and life long “disordered eater”.

I agree with you one hundred percent, diets and WLS are not the answer, and no one answer is going to fit all people. But I also believe that there is hope. There is hope for anyone to live a healthier life through knowledge and commitment. We as fitness professionals have an obligation to assist as many people as possible to live healthy lifestyles . We can achieve this by sharing our knowledge and insights. I have never had to lose 100 lbs, but I have had to lose 30, and know how frustrating it can be. I also know the personal freedom that comes from feeling empowered to be cause in the matter of my life, and how devestating it can be to feel powerless.
The way I teach women to feel powerful in taking control of their lives and weight may not be a fit for everyone, but it is one possible solution. Keep looking for the solution that fits you as an individual, believe it is possible, and it will be.
Whether you say you can or you can not, you will always be right.

queendom, it’s not really a tangent insofar as this is another issue on which people seem to split into camps, which as far as I’m concerned is an okay thing for an activist movement to do. There are people who want to have a FAM focused solely on healthy fatties, and wants the take-home message of the movement to be “fat isn’t unhealthy” (presumably they want binge eaters to have their own movement). There are others, like all of us at SP, who think that fat people with EDs (of any stripe) are better served by being part of the movement, and who try to be conscious of marginalizing them by focusing on healthy fatties to the exclusion of all others. Each of those perspectives has a place; they can’t both be right if the movement is monolithic, but that’s okay, sometimes we get to differ amongst ourselves.

Fillyjonk – thank you for taking the time to reply to my post. You have a point – it is just that some of the reactions from people in the movement left me with the feeling that my history and my struggles are somehow not “valid” (although nobody ever said that) . In any case your reply made me feel really good, mainly because one of the issues I am currently struggling with is the feeling of not being heard. I do believe I have things to give to people in the movement as well as people who struggle with accepting their body (although I am by far not as close to the goal of accepting myself and my body as part of myself as I would like to be) – but having the feeling of not being heard makes me question if that belief is correct.

I personally would love to see someone start up a site for fat people with BED/CED who want support from a HAES standpoint — i.e. starting from the idea that your ED is a problem because it makes you feel like crap, not because it makes you look like crap. Too many places, like OA, put so much emphasis on weight loss that it winds up triggering many people even worse than when they started. Many of us have found that giving up dieting/trying to lose weight has helped us make peace with food, but some people need more help than that. I’d love to see them get it. Too often they don’t, and that’s very sad.

However, I think that should start with someone who actually is in that boat. If I, or KH, managed to “normalize” our eating habits relatively effortlessly, we’re in a different boat entirely, IMHO.

queendom, I think the answer is: if you think you have things to give to people in the movement, then give them. Some may take them, others may not, but offer anyway.

I have no personal experience with BED; I’m just a garden-variety chronic restricted eater and compulsive exerciser. Not everyone in the FAM shares my experience, but that doesn’t invalidate my experience, either.

There are a lot of different ways to come to accepting yourself; talk about your way. I’m sure it will resonate with someone out there and maybe make their journey easier. That alone makes it worth doing.

And Meowser:I personally would love to see someone start up a site for fat people with BED/CED who want support from a HAES standpoint

I am actually kind of in the process (well, very much at the beginning of the process) of doing just that – even though I am still struggling myself. We will see if I manage to put it into practice.

Oh, and I just got my own blog: http://queendom.wordpress.com. Not much on there yet – I hope to change that this weekend. (The idea of an own blog is somehow thrilling and scary at the same time – hell, people put all kinds of things on the net so why shouldn’t I…)

Please read the rest of my comment with this in mind: I am sweating sharing this because it sounds like I am angry about the reactions I am about to describe, and I am TRULY not. I never felt that anyone was being callous toward me or minimizing my experiences, just that the message was similar to what queendom describes… this is not a space where BED is really that relevant. And that is OK; you can’t be all things to all people. That is why I think Meowser’s idea is good.

Re-emphasizing that I am NOT angry about this, nor do I have a disagreement with how anyone runs their own site or community… here goes. I have definitely tangled with others (admittedly mostly Kell) when I have tried to talk out my experiences with compulsive eating here. Admittedly this probably has much to do with my approach and tendency to make everything about ME ME ME even when eating is not the topic. However, I don’t think it is that fair to imply that this site has ever been all that responsive to fat compulsive/binge eaters. Certainly I am “allowed” to be here and have never been belittled, even when I bring up the topic out of turn. But I have also been told as sort of a final word on the subject, “If you are truly stuffing yourself on a daily basis, get help,” with the subtext being that either Kate is skeptical that I’m stuffing myself (i.e. maybe I consider it stuffing because of diet culture and it’s really not that bad, which is a fair point), or that if I am it’s not really important to take up FA space talking about because 99.999% of fat people do not stuff themselves. i.e. it may benefit me to talk it out but to most others it will be irrelevant tl;dr material. And honestly I really should be back in therapy for this. I have been in the past and I let it lapse because the great therapist I was seeing is now not convenient for me to go to because I switched jobs. So the advice is far from flippant.

Again, all that is fine and appropriate. BED is not the topic here. I just mainly wanted to affirm that if queendom’s experience is anything like mine, she is not making up the response she has probably gotten in FA. And I don’t think that is FA’s problem really, I just acknowledge the potential need for resources for those of us who do struggle with this problem.

And I absolutely 100% agree that in many of us, compulsive eating can grow out of the disordered eating we learn when we are told from an early age to diet and subjugate our bodies’ needs and signals. I think the issue is FA-relevant in that regard. So it is not black and white by any means and there is probably some overlap.

Why does your page talk about staying away from Halloween candy? If you really want some, do some JUMPING JACKS??? Yes, I have always found that jumping jacks take away my urge to eat. I know we should all be friendly here, but, seriously, WTF?

scg, I have no doubt that queendom isn’t making up her experience. FA is still getting its sea legs, and one of the things it’s been difficult to navigate is the question of what exactly we do about eating disorders. Here’s the biggest problem as it applies to this blog, though: Kate, SM, and I aren’t doctors. We aren’t binge eaters, either, though we’ve had our share of experience with disordered eating. So no matter how strongly we believe that the movement has a place for people with BED just as it has a place for everyone else who is struggling to rewrite their relationship with food… there’s not much we can actually say beyond “if you’re suffering, please get help.”

No, I know. And as much as it doesn’t come across on the page, I think that’s OK and appropriate and the only thing you really can or should do.

I was just trying to communicate that in my experience, this particular blog cannot really fill a lot of needs when it comes to compulsive eating. That was hard for me to “get” when I first arrived, that people here might be supportive of BED sufferers but the topic would not be a major area of discussion, and I thought maybe my point of view might be of some help to other compulsive eaters out there who might be feeling kind of alone. I thought maybe it would help others who might be like me to get some reinforcement that although it may not be a focus, that doesn’t mean that people are rejecting you, just that maybe we need to fill those needs elsewhere.

But I don’t consider that lack of focus on the topic a shortcoming. I do think you can’t be all things to all people and focusing on binge eating in particular would validate the idea that all fat people sit around and stuff themselves, a misperception which I know the movement is plagued by anyway.

I suppose there’s nothing preventing a combination of the views I outlined above: to wit, the FA movement (or at least parts of it) welcomes binge eaters and tries not to marginalize them, and binge eaters interested in HAES have their own movement too. Because both movements can be good for certain things and not for others — FA can offer binge eaters good models of HAES eating, including personal experiences from people who have overcome disordered eating habits, but it can’t necessarily offer BED-focused cameraderie and support. Whereas the existing BED support community, from what I understand, has a focus on weight loss that is not optimal for fat activist binge eaters.

I like candy better than jumping jacks. As long as it’s chocolate. I think I’d do jumping jacks to get away from that candy corn that’s all over the place this time of year. But yeah, JoEllen’s blog is definitely about weight loss fitness. Has anyone ever seen a fitness site that’s not about weight loss? That’s actually more serious than rhetorical; I like working out but I think I could use some guidance, but not the kind of guidance that’s focused on how great my abs will (supposedly) look afterwards, because that’s not why I do it.

kristin – I’m right there with ya! Looking at that site brought back bad memories of weeping for an hour after giving into temptation and eating a cookie. When did that happen? Um, any time in my teens that I actually ate a cookie! But I didn’t do it much, no cookie was worth that much crying.

fillyjonk – the thing is that doctors (at least where I live) are generally absolutely ignorant about EDs, particularly about EDs in fat people. Hell, I am a social psych grad student with a very, very strong interest in clinical psych and I tell you I know FAR more about EDs than the average doctor. Does believing that make me arrogant? Maybe… but I could tell you some very strange stories about how doctors have reacted when I told them I have an ED.

At my previous university I had a brilliant psychological counselor (who also had struggled herself with anorexia/bulimia in the past) – I helped designing an awareness week about eating disorders, and we actually thought about writing a book on the subject – and also on body acceptance (unfortunately this project was cancelled). I am not a therapist, I would never claim I am, but my problem is clearly not a lack of knowledge about EDs.

Also, the reason why I talk about my ED is not because I want sympathy or because I want people to fix me – in the end therapy or whatever can only help me to fix my problems myself. There are however several reasons why I believe that at least as far as the discussion inside the movement is concerned (possibly as opposed to what we focus on while talking to people outside of the movement) we should at times talk about EDs. First of all, although the majority of fat people don’t have EDs, there is a number that does and these people have a hard time to get help. Secondly, the distinction that was made in a different context on this blog between EDs and disordered eating is one of degree (the same could be said of many mental health issues, such as depression). Thirdly, EDs are the perfect example where the societal focus on being “the ideal weight” can get people of all sizes.

And one thing about telling people to “get help”: Going into therapy is a very personal decision and except for some very, very few cases nobody else has the right to tell someone else that he or she “needs therapy” – or at least that’s my opinion. To tell someone that he or she could profit from therapy is a completely different pair of shoes… but then a large percentage of the people that I know could profit from therapy.

My ED is – at least in my opinion – a result of a) being told by doctors that I have to lose weight from the age of three or four onwards, b) growing up with a mother who had somewhat disordered eating behavior herself and a father who has still a problem with me being fat (although my dad really tries to overcome that and although my parents were and are the most loving parents I could possibly have wished for) c) being teased about my weight and later on also bullied when I was a kid and teenager and d) possibly also a biological vulnerability. Three of those issues are in my mind directly related to fat acceptance – and that’s one of the reasons why it is almost impossible for me to talk about fat acceptance topics without mentioning my ED: self- (and therefore fat-) acceptance that goes beyond the political means to me to overcome or learn to deal with the things that have happened to me because I was fat, to accept that they were not my fault, but that it is my responsibility to live my life to the fullest although those things happened, and to help other people either by helping them overcome their pain and self-hatred or in the case of children by keeping the same thing or worse things from happening to them. For me, those things in the end also mean to overcome my ED.

FA can offer binge eaters good models of HAES eating, including personal experiences from people who have overcome disordered eating habits, but it can’t necessarily offer BED-focused cameraderie and support.

Oh, just to prevent misunderstandings… this is in no way what I am looking for. Also, none of the replies I got to what I posted here made me feel not taken seriously. However, some other (often well-meant) comments from people in the movment did.

Has anyone ever seen a fitness site that’s not about weight loss? That’s actually more serious than rhetorical; I like working out but I think I could use some guidance, but not the kind of guidance that’s focused on how great my abs will (supposedly) look afterwards, because that’s not why I do it.
Hmm… Kelly Bliss’ site?

You may want to avoid the “eating” section, but actually, for something that’s not specifically FAM-connected, it’s pretty damn enlightened (so, so close to HAES, totally into people of varying sizes being fit, etc.). She tends to focus more on what kind of nutrients are useful for building muscle and stuff like that.

She does eventually go off the “actually, you can lose weight, what you really need is lifestyle change” deep end but she starts off well, with this quote I love:

Right now I want you to take every diet book and Nutri-System/Jenny Craig/Slimfast product you have and throw it out the window. Then run downstairs and light them on fire just to make sure. Pretend you are cleansing the world of demon spawn.

queendom, all that is why BED deserves (IMO) a voice in the FAM and in the fatosphere. We’re not always the people to provide that voice, for any number of reasons, although I do try to share my experience with eating disorders (just as Rachel of The F Word does, and just as Kate tries to share her experience with dieting — HAES doesn’t spring full-fledged out of anybody’s head). But maybe you are? Not to try to push you into blogging if you’re not interested, but I know lots of non-BED fat people with typical disordered habits see this blog as a godsend because it makes them realize that there’s another option out there, and I don’t see why people with BED shouldn’t have the same thing available. I don’t think “get help” should have to mean “get a therapist” — not right away, anyway — when there can be a support community, but it sounds like your standard eating disorder support orgs either neglect or misunderstand BED, or focus too much on weight loss. So why not create another option?

Good With Cheese is one of my favorite fat blogs because she is so incredibly raw and personal about her relationship with food and her body and how hard but worthwhile it is to kick the restriction habit. I think of it as a gateway blog for people who are interested in HAES but intimidated by people like Kate who can seem as though they practice it constantly and effortlessly (no matter how often Kate refutes that notion). I don’t see why there shouldn’t be a similar voice about HAES and BED.

And I was serious about a guest post. We should wait until the current divisive shit blows over a bit first, of course. scg, I’m looking at you too.

(Now that I’ve written all that it occurs to me that Morgan at FatGrrl is overcoming compulsive eating. But she doesn’t post all that often.)

fillyjonk – I would be happy to write a guest post if you really want me to, and I am actually in the process of getting into blogging (at least I think so – but it might take me a while to really get into it because there is a lot of stuff that needs sorting out in my life right now).

Lemme talk to Kate about timing, but I’d say we’re interested in guest posts from anyone with something really interesting to say. And this is important stuff to talk about.

I’d add that it’s not just people with BED and compulsive eating who deserve to be acknowledged in the fatosphere (though they can’t necessarily be served by it) — it’s also fat bulimics and fat anorexics and fat EDNOSes, and to some extent non-fat ones too. BED isn’t a “fat problem” because eating makes you fat; it’s a “fat problem” because fat issues and food issues are strongly interlinked. FA is about political activism, yes — about how absurd it is that you can be discriminated against based on a number, or based on your perceived level of sexiness. But it’s also about personal activism — rejecting the models you’re given for interacting with food and with your body, and replacing them with ones that function. It’s where FA intersects with feminism and I think also with eating disorder awareness. I think some people don’t think FA has to intersect with feminism, or necessarily speak to our flawed methods of dealing with food and bodies. Which is fine, because those people can do more in the political activism branch of FA, and I can continue trying to form a branch that is at some level able to expand to fit everyone who wants to make peace with themselves and with eating.

My sentences are getting really long, and this isn’t work, so I should probably go home now…

I’d add that it’s not just people with BED and compulsive eating who deserve to be acknowledged in the fatosphere (though they can’t necessarily be served by it) — it’s also fat bulimics and fat anorexics and fat EDNOSes, and to some extent non-fat ones too.

I completely agree with that – although as I mentioned earlier fat anorectics don’t exist “officially” – simply because you have to be below a certain BMI to be diagnosed with anorexia (which is totally screwed up if you ask me).

Sorry I’m late to the party here, guys — needed a bit of a mental health day, where the blog is concerned.

And most of what I would have said has been covered, so I only have a couple things to add.

1. I would love a guest post on BED.

2. SCG, about the reaction when you first came along and didn’t “get” why I wasn’t super-responsive to stuff about BED, there’s one other factor to keep in mind… A LOT of people, when they first read what I write — some of whom are trolls, I suspect, and some of whom really have undiagnosed BED — comment with something like, “But I DO eat dozens of donuts in one sitting, and I DON’T ever exercise, so how dare you speak for all fat people when you claim we’re not just sedentary gluttons?” And those people, for whatever reason, just don’t let up. Even when they’re not trolls, they’re just as bad. They insist I have no right to say that fat people don’t generally overeat or underexercise, because in their minds, MOST fatties do, and people like me are the exception.

It’s actually the other way around, as you know, and that’s a point that it’s really important for me to get across. First, because the general public should know that most fat people do NOT fit the stereotype (not that those who do deserve any less respect — I just don’t like bullshit), and second, because some binge eaters apparently don’t even realize they have a disorder. The stereotype of the fatty who eats herself sick all the time is so pervasive, they assume their behavior is normal in the context of fatness. Which prevents them from getting the help that’s available (which sucks at this point, but that’s a different story).

So I might have bitten your head off because around the same time you showed up, I’d been dealing with a bunch of people trying to convince me — based solely on their own personal, disordered experience — that I don’t know what the hell I’m talking about, and fat people, as a rule, DO eat way more than they should. And those people were starting to fucking piss me off, frankly. :)

“Dang, I thought I was so quick with the link removal. NOT QUICK ENOUGH.”

The only thing I feel like it’s safe to say right now — b/c I think I haven’t sufficiently clarified my thoughts on the post (although I think they deal significantly with syntax and framing; nitpicky as that sounds, it just looks like it’s bearing itself out in the comments) — is that there’s more than one link to Jo Ellen’s site.

One may have been at the bottom of her post, but the other is embedded in her username.

“…it’s also fat bulimics and fat anorexics and fat EDNOSes, and to some extent non-fat ones too.”

Uh … thanks?

Because some of us are arguably (depending on what health professional you talk to) considered “recovered”, and are considered “thin” or “fat”depending on who we’re standing next to that day (I’m quite serious, and it’s ridiculous, and there have been actual fights) — but REGARDLESS of whom we’re standing next to, that doesn’t mean we haven’t had to deal with the prejudice and the bullshit.

And if one has had to find ways to minimize/combat the effects of prejudice (I didn’t say “eliminate”, b/c that’s difficult to do, particularly in the current climate, even with a lot of facts) — assuming arguendo that that’s an HAES objective, that can make one an effective ally in an ongoing fight.

But if the “group conclusion” is that one isn’t perceived as an effective ally because one isn’t perceived as “fat enough” — irrespective of what body drama one’s actually gone through — IMO that’s also important to know.

Because I can’t resist jumping into a conversation on eating disorders…

Queendom said:I sometimes get the feeling that people in the movement are uncomfortable to talk about eating disorders and binge eating because they don’t want to support the stereotype that fat people in general are all compulsive overeaters or binge eaters.

Absolutely. I feel the same way, and in fact wrote a post about this a few weeks ago: “Eating Disorders and the Fat Acceptance Movement.” But eating disorders aren’t about food or weight; they’re about one’s relationship with food. It must be emphasized also that BED can exist independently of obesity.

Spacedcowgirl wrote:

People in FA just prefer not to emphasize binge/compulsive eating as a big issue because most fat people are not binge/compulsive eaters, so it is not really a topic that can be addressed in depth under the umbrella of fat acceptance

I disagree. I think an interrelation between obesity and not only BED, but other eating disorders can be made. Most eating disorders start as the result of dieting – including my own – so the correlation that a naturally overweight person might develop disordered eating isn’t far fetched. Recent studies show that overweight teen girls are more than twice as likely to engage in dieting behavior, much of that extreme, disordered behavior. While fatness and eating disorders do not necessarily go hand-in-hand, nor are they mutually exclusive.

Queendom wrote:

the thing is that doctors (at least where I live) are generally absolutely ignorant about EDs, particularly about EDs in fat people.

Amen! I went through a revolving door of psychiatrists and therapists when I tried to get help for my eating disorder. I had:
– A psychiatrist tell me I still had more weight to lose (I went out and lost another 20 pounds that month);
– Another therapist who, when I told her I would allow myself one snack-sized bag of pretzels a day because I considered them to be a safe food (and I wasn’t eating much else), told me to be careful about eating pretzels because they were high in calories and sodium;
– Another therapist who seemed to have amnesia and after months of weekly appointments, would start off each session with “Now what medications are you on again…?”
– And yet another psychiatrist (who happens to be renowned for her supposed expertise in EDs) who shamed me after I described a binging episode, and the sum of her professional advice was to just “stop it.”

And ad nauseum. I also don’t agree that seeking out a therapist or counseling services is the best way to treat an ED. In fact, it was only after I abandoned treatment altogether and embarked on my own recovery plan and self-analysis, did I recover. Not to say this is the case for everyone, but I find most therapists and doctors to be woefully ignorant of the nature of an ED unless they themselves have had one.

Also, even for people lucky enough to have health insurance, mental health coverage is severely lacking. My plan is quite generous but I am still restricted to 40 visits a calendar year at $40 a copay. Now that I am seeing a shrink again primarily for treatment of ADD, but also my ED to a lesser extent, I pay $180 a month in co-pays, with additional co-pays for both anti-depressant and ADD medication – both of which factor my ED recovery. When I was living independently, even at a decent salary, I probably couldn’t afford to do this. I’m just fortunate that my husband makes more than double what I make and so I can afford treatment – so many others aren’t as lucky.

I’m glad you’ve started a blog. EDs have been around for centuries, yet our understanding of them is so elementary. And I’m tired of the rhetoric going around on ED by so-called professionals who are really out of touch with EDs. We need more people like you to offer a much-needed personal voice and perspective of EDs.

But if the “group conclusion” is that one isn’t perceived as an effective ally because one isn’t perceived as “fat enough” — irrespective of what body drama one’s actually gone through — IMO that’s also important to know.

I’m kind of confused by all the negatives here, but fwiw there is no “group conclusion” — that’s the idea of what we keep saying about different branches and people not all agreeing — but we’ve always maintained that SP is a place for people of all sizes. You don’t have to look further than the BMI project to see that. Thin and non-fat people don’t always get the same thing out of FA that fat people get, but there’s hopefully plenty for them here, and meanwhile I think we get a great deal out of having a range of sizes involved.

The stereotype of the fatty who eats herself sick all the time is so pervasive, they assume their behavior is normal in the context of fatness. Which prevents them from getting the help that’s available (which sucks at this point, but that’s a different story).

I feel like the opposite is also true — that some people think they’re binge eaters or compulsive eaters when in fact they’re just non-restrictive eaters. Kate, you’ve written about this I think. It’s hard to have a rational perspective on whether your eating is disordered or not when a) nobody has a rational perspective on eating, including doctors and b) as Rachel pointed out, mental health professionals are so criminally expensive.

Initially I added your site to the list of blogs I read because I thought it edified and helped promote self -confidence in those who had/have weight issues. I thought how wonderful that this woman would create a site so that people could feel good about themselves no matter what they weighed.

I have struggled almost my entire life being fat. I’ve had my own daughter say to me, not out of meanness, but out of the love of a 5 year old, “Mommy, I wish I could wrap both arms around you so I can squeeze you tighter.”

I’ve watched, listened, and spoken out as my oldest daughter endured the open criticism of those “perfect bodies” taunting her with their imperfect minds. Minds that were set on their destructive course from birth from their parents, grandparents, or whomever set the notion in motion. People are not born with hate, they learn it.

I’ve read many of your posts, and the posts of your followers. I’ve read some truths and some non-truths. I’ve read that losing weight is not beneficial to losing weight is beneficial. It’s kind of like the “Do what you want thing and everything will be okay.”

The reality is that doing what we want is not always okay. We need to modify some things in our lives. That’s just the way things are. People with Celiac disease can’t eat glutton or they will die. People with Diabetes must take insulin or they will die. Sometimes, whether we like it or not, we have to modify what we do to benefit ourselves.

That being said, if we are fat, or thin, or diabetic, or have Celiac Disease, or any other such thing, we need to be kind to ourselves………and to others. We can not spread a message that eating gluten is ok for Celiac disease, or that not taking insulin is ok if you are a diabetic, or that being fat is ok when you can’t breath when you walk up a flight of stairs. Those kinds of testimonies are just cruel and harmful.

If you are fat and healthy and content with that…..be happy for yourself and for others. If you are fat and want to lose weight, be encouraging to those that wish to do so.

The more I read here, the more I feel the hatred that consumes those who are not the same…..whether that same be fat or skinny.

Now, before you all get your panties up in a bunch, I did not say that you told diabetics not to take insulin or that you told people with Celiac disease to eat glutton, but, unfortunately, telling a person that can’t breathe or walk merely because they weigh too much to support those basic life functions is the same thing.

The message should be…be healthy at any weight and feel good about yourself at any weight.

But….as you say…..this is your blog and you can say whatever you like.

Good god. I wish things were less busy at work so I could write another post and we could get onto another topic, because I’m getting right sick of people coming in here to tell KATE, OF ALL PEOPLE, that we should STOP OPPRESSING FAT PEOPLE and that you can be HEALTHY AT EVERY SIZE. Christ on a CRUTCH, people. Reading. Look into it.

I’m particularly flummoxed by the trope, which has happened a couple times now in different comments, of “I don’t think we should tell people [completely over-the-top straw man position]. Not that you said that.” Hey, I don’t usually speak up, but I just had to say that I don’t think that rabid pit bulls should be doused in gasoline and set loose in this city’s Alzheimer wards! Not that you said that but I think it’s a really irresponsible position, Kate.

I’m sorry to get so vocally irritated, and I’ve certainly appreciated much of the discussion on this thread. (Realistically I”m just getting my “panties in a bunch” — ugh — about the most recent comment.) But please, if you seem to see Kate or me or SM saying that fat people should be oppressed or that you should eat nothing but donuts or that people with EDs don’t belong in the movement or some other claim that is in total contradiction with everything else we have ever written here, please consider whether that’s really what was said.

(Sombody correct me if I’m wrong), but Kate, FJ, and SM aren’t saying that everybody should just eat what they want and everything will be okay. What they ARE saying is that changing your habits SOLELY for the purpose of losing weight is SETTING YOURSELF UP FOR FAILURE. Not only that, but 9 times out of 10, you’re going to end up worse off than you were to begin with.

Of course we should all eat healthily and exercise, but to do so just for the purposes of losing weight is… well… pointless. Not only will you most likely be fatter at the end than you were at the beginning, but it’s going to be hell on your self-esteem, self-worth, and self-image. Because we’re constantly getting it shoved down our throats that diets don’t work simply because WE’RE not applying ourselves. We’re told that it’s OUR fault that it didn’t work, when the reality is that the whole idea of dieting is flawed in the first place.

And I’d like to point something out.The message should be…be healthy at any weight and feel good about yourself at any weight.

Um… that IS the message.

But like I said, with all the comments, methinks you’re just getting confused as to what we ARE trying to say.

I’m a first-time visitor and at first, this entry seemed a bit like bad advice. But upon reading comments, I see where you’re coming from. I’m guessing it lacked context.

Now, I think weight stems from both genetics and lifestyle. If your lifestyle is what’s causing you to be fat, then you should change it. Dieting is often viewed as a quick fix, but lifestyle changes are for the long-term. Even if you don’t lose weight, you’ll be healthier, which I think is what you’re advocating.

When I was borderline morbidly obese, I could have just blamed my genes. But I knew lifestyle was the cause. It wasn’t uncommon for me to wash down a bag of Doritos with some Mountain Dew. But the obesity and diabetes that runs in my family scared me, so I resolved to change (not on New Years'; the way I view it, it’s now or never). I’ve lost about 80 pounds and want to lose another 40. I do believe success is a matter of wanting to, instead of thinking you need to.

On the other hand, saying it’s all lifestyle is equally naive. I think there’s much truth in Sheldon’s classification of body types: ectomorphs (skinny people), endomorphs (fat people), and mesomorphs (muscular people). Ectomorphs can be skinny but unhealthy and endomorphs can be fit but fat. I think I’m a mesomorph, which is quite helpful; I believe that I can lose down to a “healthy” weight and maintain it, if I’m careful not to slip into my old ways (which I don’t think I will).

In summary, it’s a combination of both factors, I believe. Some people will plateau and need to just be happy fat. But if you can lose weight through lifestyle changes and be thin, I think you should. Genetics should never be used as an excuse, but you should come to the realization that it’s the cause if and only if it actually is.

I, for one, would be interested in reading a post about BED. Both the posts on WLS were very enlightening, and honestly, it wasn’t that damned hard to see where the Mistresses of This Blog are coming from on the issue.

As somone who has dieted for, um, 30 years, I thought of my bigger meals as compulsive eating for the longest time. In fact, it was just a reaction to being deprived. I wonder how many other long-term dieters have the same misconception.

Sorry, I just found this a kneeslapping typo. Also, it’s factually wrong. There are varying degrees of celiac disease. Not all will result in instant death if one eats even a tiny amount of gluten. Probably a good idea to avoid gluten if you know you have the disease, yes, because crapping your pants or throwing up every time you eat it isn’t a barrel of laughs either. But severity does vary greatly.

People with Diabetes must take insulin or they will die.

IF they are insulin dependent type I diabetics and their bodies don’t manufacture their own insulin, yes. But there are other types. Moving on…

We can not spread a message that eating gluten is ok for Celiac disease, or that not taking insulin is ok if you are a diabetic, or that being fat is ok when you can’t breath (sic) when you walk up a flight of stairs. Those kinds of testimonies are just cruel and harmful.

Uh…buh? What was the point of KH’s post, exactly? And Mariellen’s too? And, oh, almost every single post on this site ever? Ooh ooh, Mr. Kotter, I know! It’s…wait a minute…we don’t know how to make most fat people permanently thin, even if they really really really really “need it.”

Avoiding gluten or taking insulin when medically necessary is something over which you have direct control. Whether or not you can become permanently thin is a matter of chance, no matter how hard you try and try and try and try and try, no matter if you huff and puff going up the stairs. A few people can achieve it with no turning back; most cannot. Telling fat people otherwise — which is what we have to hear and hear and hear and hear EVERY FUCKING GODDAMNED DAY OF OUR LIVES EVERYWHERE WE TURN — is what’s “cruel and harmful,” lady. If I tell you I know the way to a thin body for all, I’m stealing your money and your time. And I can’t do that.

Hey, I don’t usually speak up, but I just had to say that I don’t think that rabid pit bulls should be doused in gasoline and set loose in this city’s Alzheimer wards! Not that you said that but I think it’s a really irresponsible position, Kate.

Shit! That’s what I was going to write about tomorrow.

Also, Fillyjonk, I don’t think you should tell people it’s okay to eat lead paint, steal your neighbor’s toaster oven, then dance naked through the frozen food aisle of your local Safeway, singing “John Jacob Jingleheimer Schmidt” in Spanish (which I believe is Juan Paco Pedro de Lamar).

Not that that’s what you’re saying, but if you were… I would be totes offended.

fillyjonk said: “Hey, I don’t usually speak up, but I just had to say that I don’t think that rabid pit bulls should be doused in gasoline and set loose in this city’s Alzheimer wards! Not that you said that but I think it’s a really irresponsible position, Kate.”

OOH, is this where i get to give the “i have a pit bull and she would never hurt a fly so you are all stereotyping bastards for further demonization of the breed when it is the DEED that should be punished” diatribe? Because it’s been a few hours since i last went into that, and i was starting to feel lonely without my angst. ;)

I’m only just now catching up on the comments here, so we’re prolly well past this particular subject/aspect of the discussion, but um, i’m stubborn and wanna stick my two cents in.

queendom: I definitely agree that a mere “get help” is entirely inadequate. While it’s true that people with EDs need help, they also need emotional support. It’s such a strong and scary subject, i think many people are afraid to give potentially bad advice for fear of making matters worse. Even then, if a person goes into therapy, it’s one of those things that you’re only going to get out of it what you’re willing to put into it. For the people who are not willing to get well, no amount of therapy will do them a lick of good. I think different activities that can be considered therapeutic, and as such they are definitely worth pursuing… but i wouldn’t tell someone to just figure it out entirely on their own any more than i would say “everyone needs to find their own path to heart surgery.”

I think it’s already been mentioned, but the FA community is perhaps a bit lacking in resources in this regard, which is one of the reasons i’m so interested to see what you decide to do with your blog. I don’t think it’s always necessarily from fear of playing into stereotypes, but perhaps more a fear of openly discussing such… emotionally intimate matters. In my (granted, limited) experience with EDs, they tend to be very secretive, very private.

My own experience with chronic pain and health issues, especially “invisible” ones such as fibromyalgia or endometriosis, is that there appears to be a fair bit of taboo when it comes to discussing chronic pain. This taboo seems to also play out with emotional pain as well – and i think EDs certainly qualify as such.

It’s scary to talk about physical pain, because the person hearing it doesn’t know how to react – should they offer *hugs*, should they try to troubleshoot the problem, offer suggestions for solutions… many people are uncomfortable in this situation because they just don’t have the resources to know the best reaction. Also, the “best response” varies from person to person. Some people want coddling, others want factual information on potential solutions, etc. Again, i imagine that the same sort of thing is true with regards to openly discussing EDs. I could be wrong here, and won’t take it personally if you say i am – i have little to no experience in dealing with EDs on either side of the conversation.

There are some situations where, if you’ve been there, then no explanation is necessary… but if you haven’t, none is possible. I can’t fathom what it must be like to have bulemia, because i never have. I couldn’t pretend to know what to say to someone who came to me for help with that, and it would be unethical and potentially dangerous for me to do more than attempt to offer moral support. Even then – what people consider supportive varies based on their personality and state of mind/emotion.

It’s really a difficult situation, and i would love for there to be more information out there about these things. Help us to help others – even if it’s “just” another blog where we can say “you know, we don’t know much about what you’re going through, but we know you’re not alone; you might want to check out what this person has to say about it and see if they can be of any assistance to you.”

NO! NOW I’M GONNA POUT AND PASSIVE-AGGRESSIVELY INSERT MYSELF INTO YOUR COMMENT THREADS JUST TO REMIND YOU THAT YOU ARE A BAD PERSON FOR NOT THINKING MY DOG IS MADE OF 100% PURE AWESOMENESS. I HATE YOU AND AM NOT LEAVING. SO THERE.

I definitely agree that a mere “get help” is entirely inadequate.
First of all, I have a problem with the idea that people with EDs necessarily need help – and that others can decide if they do. I have no problem if people suggest that they could use some help, but needing implies to me that you “have to” get help and that you are possibly not in the position to decide if you want it or not. There are people who overcome their ED on their own, without outside intervention. A friend of mine read an article about EDs when she was bulimic, realized that what was described was exactly what she was doing and experiencing, read about the possibly grave health consequences and stopped purging the same day and never did it again. Was she cured? No, but she had made a first step in the direction of healing. Not everyone could have acted the same way she did (I, for one, couldn’t, at least not up to now), but as long as people don’t see that it would be useful for them/ don’t decide to accept help no intervention forced on them can possibly help them to heal.
Also, as I said earlier, in my opinion the difference between EDs and disordered eating (something a large number of people experience in this society) is one of degree – and even once you have “passed” the line to a full-blown eating disorder the severity varies not only between persons but in my experience also with time. I am not sure when exactly I developed BED, I think I definitely fulfilled the diagnostic criteria when I was about 14 – that was 14 years ago (I was diagnosed much, much later – and basically after I already knew myself that I had BED). From that time on I had times when I had full blown episodes of BED, times when I was dieting like crazy, and times when I was more or less okay with myself and did not pay too much attention to my eating (although those times were rare).

It’s such a strong and scary subject, I think many people are afraid to give potentially bad advice for fear of making matters worse.

This is part of it, I think. But then you could say that about almost every subject that deals with strong, negative emotions, not only chronic pain or EDs, but also mourning for a loved one, hell, sometimes even things like losing your job. Those things are part of human life, and I for one do believe that they should be treated as such. When I talk about my ED I don’t expect people to tell me how to overcome it, and I am usually not begging for sympathy either. The reasons why I do speak out about it differ from situation to situation. One of the reasons is that I do not want to hide that side of me anymore. However, if people reply to me by saying that I should get/ “need” professional help and then fall silent the message that I get is that they actually feel more comfortable with me if I hide my ED. I am not going to say everyone with an ED feels the same – I obviously can only speak for myself. But openly saying that I have an ED, educating others about EDs and eating disordered behaviors, pointing out the prevalence those behaviors in today’s society, and also trying to speak up so that today’s children won’t have to go any longer through the same experiences that in my opinion contributed to me developing an ED have been some of the most liberating and self-empowering things I have ever done. That’s another problem I have with being told that I “need” help – I have felt in the need of help, that is, helpless on my own, long enough and it just made me feel worse.

I think different activities that can be considered therapeutic, and as such they are definitely worth pursuing… but I wouldn’t tell someone to just figure it out entirely on their own any more than I would say “everyone needs to find their own path to heart surgery.”
I don’t think that you really can compare psychological disorders with a clearly physiological disease such as heart disease. I know that many people argue that you can/ should but I don’t think that this is a useful approach. (For example, I can’t hear the assertion that depression is just “a chemical imbalance in your brain” – yes, if you are depressed there are differences in your brain compared to a person who is not depressed, but neither is the difference the same for every depressed person, nor does this capture the nature of depression very well, if you ask me. Not to mention that you could then also say that anger or love-sickness or whatever are just chemical imbalances in the brain).
An ED can become life-threatening, I am not trying to deny that, and in those cases there is probably a good reason to intervene, but those interventions cannot cure the ED (which I see defined by emotions, thoughts, and the resulting actions – not by the physical outcome). Plus, the actual therapies for EDs do not necessarily work for every person the same way and as I said before there are a lot of doctors/ therapists out there who have absolutely no clue. Also, just as applied medicine is not always scientifically based but simply uses what “seems to work” so is clinical psych (maybe even more so). For example there has been the ridiculous assumption for a while that people who overeat compulsively are trying to build up a “protective layer of fat” because they don’t want to deal with the outside world. Well, I don’t know about you, but my fat has never ever protected me from emotional pain. I am angry about theories like this – and I believe that those things need to be addressed on a societal level.

First of all, I have a problem with the idea that people with EDs necessarily need help

Queendom, I read your whole comment, and I hear what you’re saying, but that line struck me as something I’d expect to hear on a pro-ana site, not Shapely Prose.

The “help” available largely sucks, which I’ve written about before. But I do not agree that “you need help” is bad advice for someone with an eating disorder. I understand why you, personally, see it as disempowering, but that doesn’t mean it’s bad advice, generally speaking.

those interventions cannot cure the ED (which I see defined by emotions, thoughts, and the resulting actions – not by the physical outcome).

That’s an awfully big assumption, especially when it comes to BED. I don’t think it’s defined by the physical outcome, either, but I think there might very well be a physiological basis for BED, as suggested by research into the hormones that control appetite. The fact is, we just don’t know what causes it yet, and don’t think it’s safe to assume it’s entirely psychological. And for my money, that’s one of the reasons why the help that’s out there right now is inadequate.

As for the comparison to depression, I would tell anyone suffering from depression to seek help as well. Yes, it’s different for everyone, and no, not every doctor or every treatment addresses it effectively. But it is not something people should be expected to overcome by themselves, and in many cases, it’s not something people can overcome by themselves.

I’m mostly keeping my mouth shut, and listening, and trying to learn in this particular convo, but this…

For example there has been the ridiculous assumption for a while that people who overeat compulsively are trying to build up a “protective layer of fat” because they don’t want to deal with the outside world. Well, I don’t know about you, but my fat has never ever protected me from emotional pain.

…FUCKING YES!!! I can’t tell you how badly that “theory” fucked me over when it was applied to me — after I was raped. I wasn’t even eating compulsively at that point, WTH??

Sorry to interrupt with the personal revelation/epiphany, please continue…

Hey Guys, late returning to the party, but I’m sorry if I contributed to any kind of kerfuffle here. For what it’s worth I think the conversation in this thread is potentially very worthwhile for newer readers (well, except the part about how if you can lose weight, you should–personally I think if you CAN refrain from posting sanctimoniously about your weight loss on FA blogs, you SHOULD; YOU CAN DO IT!–and the fucking jumping jacks all that shit :p). I look forward to reading queendom’s blog and guest post because I think there is a definite need there. I also appreciate the heads-up on other fat bloggers who post about these issues. It is so complicated because as many have noted, disordered eating is so wrapped up in one’s relationship with food and one’s relationship to one’s body, so it is almost impossible for fat OR thin women not to be affected by it in one way or another. So it is going to come into FA and the question is to what extent and how much it is going to be a focus.

Anyway, I think I was trying to explain the response I got when I first arrived (though that response was not particularly cold or insensitive at all; mainly, in my ignorance, I was surprised that more in the community did not seem to identify with my experience) for anyone who might be lurking and feeling “rejected” because ED’s–particularly compulsive eating and particularly because of the troll angle, which I did eventually come to understand, Kate–are not a primary focus here. I really think that understanding of this has to come in the context of “getting” that most fat people are not compulsive eaters.

Speaking for myself, I know when I first found SP, I still believed that since I eat compulsively and am fat, that must mean this is a common thing among fat people. (It may also explain part of the reason why Overcoming Overeating did not “work” for me, because like many “intuitive eating” philosophies, it promises weight loss, which we now know is not necessarily going to happen and should not be your reason for attempting to normalize your eating, because it’s a crapshoot).

Like the idea that WLS is not opposed because it makes you thin, it is opposed because we consider it dangerous and ineffective, the idea that most fat people eat normally (especially if you yourself do not) can be very hard to wrap your brain around when you first hear it. I was offering my thoughts mainly in the hope that they could act as “shorthand” for any newbies like me who were struggling with (or had not yet absorbed) these concepts.

Once I understood myself that compulsive eating is not any more a “fat person’s issue” than a “thin person’s issue,” the idea that FA could encompass and support me as a disordered eater, but could not be ABOUT my disordered eating–whereas other more specialized communities could perhaps focus on this more–became much easier to grasp.

Anyway, thanks for hearing me out on this and I have enjoyed the discussion.

I have no problem if people suggest that they could use some help, but needing implies to me that you “have to” get help and that you are possibly not in the position to decide if you want it or not.

Actually, I disagree with you on this. While I do think any treatment plan will be most effective if the ED sufferer truly wants to get help, I don’t think one with an ED is entirely mentally capable of making informed decisions regarding their own health. When you’re in the midst of the disorder, it’s very difficult to make rational, educated decisions about your own health, hence why so many engage in behaviors so very hazardous to health. This is compounded by physiological changes wrought by malnutrition, chemical imbalances, feelings of shame, etc…

There are lots of 70-pound anorectics who will steadfastly deny that they need help. I remember writhing in agony one night after downing syrup of ipecac, calling Poison Control when it didn’t come back up as it’s supposed to, and driving to the emergency room only to turn around half-way because I didn’t think I needed professional help. That’s how fucked up your degree of rationality becomes when you have an eating disorder.

And, saying that it’s one’s choice to get help is like saying that one chose to get an eating disorder. And I don’t think EDs are a matter of choice.

I don’t think traditional therapies were all that effective, and I don’t recommend them to everyone. Yet I agree with Kate in that it is the most ethically responsible avenue to suggest to someone with an ED, especially if you have no personal experience or knowledge in the area.

For me, I think I had to go down that traditional therapy route, and seeing just how very ineffective it was actually galvanized me to embark on my own plan of recovery.

Queendom, I read your whole comment, and I hear what you’re saying, but that line struck me as something I’d expect to hear on a pro-ana site, not Shapely Prose.

Kate, as I am not saying that you should not intervene if you have a friend/ loved one/ whatever who does show the signs of an eating disorder – but I truly believe that pointing out your observations and suggesting to that person to seek help is in most cases far more productive and helpful than to insist that they need help – partially because it signals that you take the person’s subjective experiences serious. I admit that this view might be colored by my personal story as well as by watching my older sister who had anorexia when she was 15 (and thankfully recoverd), though.

That’s an awfully big assumption, especially when it comes to BED. I don’t think it’s defined by the physical outcome, either, but I think there might very well be a physiological basis for BED, as suggested by research into the hormones that control appetite. The fact is, we just don’t know what causes it yet, and don’t think it’s safe to assume it’s entirely psychological. And for my money, that’s one of the reasons why the help that’s out there right now is inadequate.

Could you point me to the research you are referring to, please? I might miss something here. And I am not saying that eating disorders have not physical basis at all. However, I do believe that this physical basis is not the only determinant in developing an eating disorder (or not). At least not in the large majority of cases. To go back to the depression comparison: There are people whose depression does not seem to have any other reason than a malfunction in the brain – however, for many other people depression results from a mixture of biological vulnerability and other factors.

Also, let me state that I am in no way anti-treatment – but I do stand by my point that psychological interventions only work if the affected person is to a large degree in control. And I also do not think that physical intervention alone will cure any eating disorder – it might suppress it, it might prevent physiological damage, but it will not cure it. (As I said above if you have studies that question this view – well, I would definitely be interested to look into them.)

I am not advocating that people should overcome depression or an ED by themselves (hell, I am chronically depressed, and I have been seeking help several times in the past, plus I am in therapy in the present). I believe it is vital to point out to people that help is available (and to make sure that this is actually true in all cases). But I do not believe that help that is forced on a person or that does not take the wishes of the individual into account is really useful. People with EDs often have the feeling of a lack of control in their lives (I certainly do), and depression most certainly does go with a feeling of helplessness. To strengthen those feelings by telling people what is right for them is to my mind very counterproductive. (I should note that I believe there are a very few exceptions, such as when people are acutely suicidal. However, interventions in those situations are often a two-sided sword because they can destroy trust in the intervening person.)

Hi all,
First post here ever, and what a great discussion! Just wanted to pop in to say: I am a happy, fat, HAES positive therapist who does some ED and addiction work. I recovered from my BED using the Overcoming Overeating approach, which is very weight neutral.

Carol Munter and Jane Hirschmann (who write the OO book are very clear to say that recovery is NOT about losing weight, although sometimes when people stop using food compulsively some weight loss can occur. They are all about treating your body lovingly and taking good care of it whatever your size.

I think it’s a great resource for large people deaing with compulsive eating/binge eating/EDNOS. Their second book “When Women Stop Hating Their Bodies” is also fabulous.

Thanks, Kate. And thanks for wading through my comments. I will shut up on the topic now because I think after 103294871092347 words I have finally somewhat accurately transferred what was in my brain to the screen. :)

This is said so often that it is a truism, but I think it really is correct, and not as facile as it sounds, that “problems become more manageable when you talk to someone.” I know that I have been convinced more than once in the past that I was so hopelessly screwed up that there was no point in even going to therapy. Then I forced myself to go, not feeling hopeful about it, and found that I was certainly not the only one with my particular issue, that it was even a common and named issue, and that it was something that could potentially be tackled. It is hard even to remember how these periods of hopelessness and irretrievably-screwed-up-ness feel when I am not in the middle of one, and for this reason they can take me by surprise the next time a problem gets so bad that I see no way out. So I agree 100% with Rachel, a person who needs help is not always in a position to understand that they need it or even to believe that there is any help for them, and hearing it from others whose opinion you trust can be a tiny bit of reinforcement that things are not OK right now, but help is out there.

Also, let me state that I am in no way anti-treatment – but I do stand by my point that psychological interventions only work if the affected person is to a large degree in control.

Okay – I understand where you’re coming from on this, but I need to point out that people with an ED are mentally incapable of making healthy decisions for themselves. Therefore, some degree of “control” has to be removed from their behalf, and placed onto someone who can make informed, educated decisions about their health.

ED are all about control, absolutely. But ANY form of treatment will involve a dismantling of often rigid and disordered behaviors which define control for that person. In order for treatment to be successful, the ED sufferer must learn to relinquish control, and learn new forms of empowerment.

And I also do not think that physical intervention alone will cure any eating disorder – it might suppress it, it might prevent physiological damage, but it will not cure it.

Physical intervention alone will not cure an ED, but it can greatly improve one’s mental outlook and capability to then address underlying issues. If you look at past studies on the nation’s first settlement at Jamestown or the Minnesota Starvation studies of WWII, you will find that malnutrition brings about physiological and psychological symptoms bearing an uncanny resemblance to that of an eating disorder. Getting someone back to a healthy body weight or stopping the binge/purge or binge cycles gives them the much-needed frame of mind to then do the hard work in addressing and changing their eating disorder behaviors.

To strengthen those feelings by telling people what is right for them is to my mind very counterproductive. (I should note that I believe there are a very few exceptions, such as when people are acutely suicidal…

Nor is coddling and passively supporting one’s ED productive, either. And I would like to point out – eating disorders are deadly and require the degree of seriousness one would apply to threats of suicide. This isn’t to say that you have one committed to an ED facility or insane asylum – then the person just takes the disorder underground – but if you know that someone has an ED and you don’t make serious attempts to get them into some kind of treatment plan or at least eating healthier, you’re doing the ED sufferer a grave disservice.

Nor is coddling and passively supporting one’s ED productive, either. And I would like to point out – eating disorders are deadly and require the degree of seriousness one would apply to threats of suicide. This isn’t to say that you have one committed to an ED facility or insane asylum – then the person just takes the disorder underground – but if you know that someone has an ED and you don’t make serious attempts to get them into some kind of treatment plan or at least eating healthier, you’re doing the ED sufferer a grave disservice.

I don’t think I ever spoke of coddling of passively supporting an ED – and I think I made that clear. And I know the studies that show what happens to people who are starved. I still do not believe that forcing treatment on people – forcing in the sense of getting them into treatment against their will is productive in any way. There are exceptions – and I have said that, but they are few.

I haven’t been reading this blog for very long, and this is my first time commenting. I hope sharing some of my experiences won’t be totally inappropriate.

I first want to say how much I appreciate that this blog exists. I’m actually pretty new to the FA movement in general, and have another friend to thank for introducing me to it. It’s been… well, it’s like I finally feel like there are people out there I can relate to as far as my body issues are concerned. I don’t feel like the “fat freak” anymore who needs to change. I think finding sites like this will help me learn to be gentler with, and more accepting of, myself. I’m not there yet, but I’m working on it.

I’m somewhat tall and have always had a large frame. I was never thin, but looking bat at pictures of when I was a kid, I realized I wasn’t really fat either. But as far back as I can remember (from both family and other people) I’ve been treated as though I was. I probably started to really gain weight around puberty and ranged from a size 18-22 by the time I was in high school.

I gained more weight after I had gotten married (just like a statistic, go figure) and after a few years I was about 270. Around that time my (now ex-)husband and I wanted to start having kids. I went to my then-OB/GYN, all excited about the prospect about being a mom. My (very thin and petite) doctor informed me that I should seriously think about getting a gastric bypass before I even considered trying to get pregnant. She went on to tell me how bad getting pregnant at my current weight would be and how much harm it would bring to the baby. I left in tears. And never went back.

My whole life I’ve been dealing with health practitioners of all kinds (from gynecologists to chiropractors to therapists) telling me “You really should think about losing weight”, as if the idea had never come to me. Just seeing a scale in a doctor’s office fills me with dread. I’ve done the whole “take off everything you possibly can” trick, too. It’s gotten to the point where I frankly avoid going to the doctor whenever I can (probably not a good idea when you have mental health issues, but oh well).

I hope this comment doesn’t seem pointless, but I’ve gotten to the point in my life (I’ll be thirty in a couple of years) where I’m just damn tired of hating myself so much. I’m tired of being so disgusted with my body. I have to admit that my lifestyle isn’t the healthiest. There are changes I would like to make to be HAES. And I’ve been reinforcing the idea that this does not mean losing weight. Dealing with depression makes it difficult to motivate myself to do much of anything besides go to work. Not to mention how I’ve psyched myself out of exercising. But I hope I can retrain my mind to realize that I can find ways to be active that I enjoy– and not feel like I have to do them in order to be more acceptable to… whoever.

I know the motivations for my current eating and activity habits are deep-set (for example being a kid and being told never to waste food yet still being singled out for eating “so much”) and will be tough to overcome. But it’s nice to know that there are resources out there for me, and perhaps, if I’m lucky, a support system as well.

Queendom said: “I still do not believe that forcing treatment on people – forcing in the sense of getting them into treatment against their will is productive in any way. There are exceptions – and I have said that, but they are few.”

I’m not entirely sure I agree with you, on this, though I think I understand where you’re coming from.

I was anorexic for many, many years and have known quite a few anorexics, ranging from those who managed to keep it a secret (and only shared it with other ED sufferers) and those who had to be forced into therapy or institutions.

I’ve seen a LOT of young girls get to a point where the only option was forcing them to get treatment, otherwise they would have totally destroyed their kidneys, among other vital organs. I have a friend now who, after years of having a healthy diet, started to suffer the consequences of her years as an anorexic.

Most of my ED suffering friends say the same thing: if someone close to them hadn’t forced them to look at themselves, or forced them into some kind of program, they would have kept on starving themselves until they were in the hospital being force-fed with a tube.

EDs are a psychological sickness. I realise you know this but I feel it bears repeating. I used to stare at myself in the mirror and think my BONES were fat, and I also KNEW I wasn’t sick. My only problem was being ‘fat’. Whenever someone broached the subject with me, I’d get SO ANGRY that they dared say I was ill. Couldn’t they see I was hideous and doing what was necessary to be ‘healthy’ and beautiful and worthy? Why were they standing in the way of my efforts to be the person I wanted to be?

If my parents hadn’t put their foot down and involved my school to FORCE treatment upon me, I honestly believe I wouldn’t be alive today.

And my story really isn’t an exception. From what I’ve read and seen and experienced, it’s the norm for anorexics.

I don’t feel right commenting on whether that’s the norm for other ED sufferers since I don’t want to speak for anyone else.

If the nature of a disease is total self-loathing, denial, and an inability to realise that something is wrong, is there actually any other option but an outside influence forcing you to seek treatment? Is it even possible to be aware that what you’re doing is wrong, or unhealthy?

A lot of people often argue that ED sufferers realise they’re doing something wrong because they try to hide it from others, but my personal experience is that we KNOW we’re right; it’s everyone else who is wrong, and that’s why we hide it, because we don’t want to be hassled.

If part of me had known that I was sick, I would have sort help, or at least considered it. But I never did. Not once.

A lot of people often argue that ED sufferers realise they’re doing something wrong because they try to hide it from others, but my personal experience is that we KNOW we’re right; it’s everyone else who is wrong, and that’s why we hide it, because we don’t want to be hassled.

I am wondering if there are differences between the single EDs in this case. I for my part have never met someone with BED who did not know that SOMETHING was wrong – although they might not have realized that they have an eating disorder. And I would suspect that most bulimics do know that something is wrong, too.

What I would like to know from you, though, is how you actually CAN force someone to seriously undergo treatment (other than forcing them to eat) if the respective person is not on some level willing to do so?

Also, what I don’t quite understand either is when you decide that someone cannot decide for themselves anymore… when do you draw the line? While the diagnostic criteria for psychological disorders are usually not arbitrary content wise they are often quite arbitrary were they draw the line because psychological health does come on many dimension as a continuum instead of in two clear categories – disordered and healthy. A lot of people in society – I would say the majority, at least of young women – show some kind of disordered eating behavior, yet they certainly do not meet the criteria for a full-blown eating disorder. But you could argue that the majority of those people are in denial that they have problematic relationship with food. In addition, the people who do make the decision that someone is not able to decide for themselves anymore are quite biased in their decisions, too.

I am not arguing that nobody ever gets in a situation where they don’t see that they need help, where they are not able to decide for themselves anymore – in fact I believe it can happen to any of us under certain circumstances. However, the same people who say to others that they “need help” often seem deny that some of their own decisions are based on wrong or even “disordered” beliefs and assumptions. And I guess this is where a large part of my position comes from – together with some personal experiences.

Queendom wrote: “What I would like to know from you, though, is how you actually CAN force someone to seriously undergo treatment (other than forcing them to eat) if the respective person is not on some level willing to do so?”

Some of it is forcing anorexics to eat, some of it is talking to them in an environment where they can’t run away, or putting them into an environment where they can’t indulge their illness. I had my scales confiscated, and I had my day structured in a way that prevented me from constantly running off to exercise, or to throw away the food I’d been hiding/pocketing about my person.

Sometimes it involves scaring the individual with the truth. Part of my sickness was a total fear of doctors. I don’t know why; maybe I knew they’d force me to stop? Either way, the threat of being dragged to the doctor, possibly even the hospital, and having a food shoved down my throat if I didn’t start eating was enough to make me increase my calorie intake. Not a lot, of course, since it’s counter-productive to force a lot of food on an anorexic all at once, but enough to start me off.

And, oddly, once that process started, things started to change. At first I was resentful, even hateful, and felt renewed vigour for my ’cause’, but over time that all started to change. I used to feel almost high from my self-inflicted starvation, and being forced to change my habits and compulsions triggered a psychological change that brought me down from that high and made me see things differently.

I still wanted to be skinny but without that high I also felt darkly, blackly miserable. I suppose a switch went and my focus went from “must be skinny at all costs” to “must feel better”, and when someone offers you a path that leads away from utter self-loathing, you do feel better, and you do follow it.

Or, at least, you try to. Sadly, some anorexia sufferers can never overcome their compulsions and will die young.

“Also, what I don’t quite understand either is when you decide that someone cannot decide for themselves anymore… when do you draw the line?”

Good question, and I’m not sure I have an answer to that.

It’s a troubling issue, and I feel out of my depth to try and answer such a weighty question. That said, even if we are looking at a problematic situation or ‘slippery slope’ it doesn’t change the fact that there are a lot of sick people out there who legitimately require help and suffer from a disease which, by it’s very nature, prevents the sufferer from realising and/or choosing that they need help and should seek it out.

Now, you mention that you’ve met BED sufferers who are aware that something is wrong. The way I see it, though, isn’t there quite a big difference between knowing intellectually that something is wrong and actually internalising that? Even if they’re not in total denial, or even total ignorance due to the disease creating such a mindset, is it really so different from the anorexics I’ve described? I mean, even if you know something isn’t right, does that necessarily mean you’re at all interested in seeking help or therapy?

At the risk of sounding like a total nutcase or stereotype, after my ED, I fell into depression and started cutting myself just so I’d feel something. I KNEW that it was wrong and wasn’t healthy to slice up my arms and legs, but I also knew that it made me feel something and it relieved the pressure in my head. I wasn’t interested in seeking alternative methods of care because my method, messed up through it was, worked for me.

Could the same not be said for ED sufferers? At what point does it become our responsibility as loved ones, friends, family members, even health practitioners, to step in and say, “Hey, I know you’re hurting, and I know you think this is working for you, but there are better methods available at your disposal and I feel it my responsibility to ensure you try them”?

And, please, don’t misinterpret how hard it is for me to say such. I am ALL about an individual’s bodily autonomy and right to choose their own method of care, but it’s such a tricky issue when we’re talking about illnesses that can lead to actual self destruction.

I definitely see the points you are making, Queendom, and I am not at all trying to undermine your personal feelings and opinions on this subject. I think we’re approaching this issue from two very different places, and I can only consider that a good thing, really, since it forces me to look at the issue from a different vantage point.

There doesn’t seem to be enough discussion about such issues, and I appreciate the chance to talk about it. :)

Queendom, with respect, I’ve deleted your most recent comment, because you have made your feelings on the matter very clear already, and it remains the position of this blog that trying to help people with eating disorders is a good thing, for all the reasons Rachel and others have mentioned.

If you want me to e-mail you that last comment so you can post it on your own blog, let me know.

Kate – I respect your decision, and I will therefore not post to this thread anymore. However I have two last comments to make: a) the post you deleted was written to illustrate why I have the position I do have – not to quiet others or say they are wrong. I was talking about my experiences in there, and it was a direct reply to Gemma (who obviously has different experiences) b) I NEVER said that trying to help people with EDs is not a good thing. I just disagreed with (supposedly the majority of people here) how that help should look like – or at least should have looked like for me. (I do not believe in leaving people alone with their problems, no matter how those problems look like.)

Gemma, I realize these are complicated psychological disorders so no answer can be this trite and simple, but do you think the lack of understanding on the part of anorexics that what they are doing is wrong might have something to do with the fact that restricting/dieting behaviors are condoned by society to some extent? Unless someone hits 80 lbs. you are still going to have plenty of clueless people–even people who see that the person eats little or nothing–who think that they “look great” and are “just trying to be healthier.” So many of us (without a true understanding of the horror experienced by sufferers, of course) have secretly wished at one time or another that we had the “self-control” (ha) required to be anorexic. People say anorexia is horrifying but I wonder how much they really believe that, as long as the person is slim and looks “healthy.” I think that a lot of people consciously or subconsciously believe you should eat as little as you need to to be “normal weight” or “underweight.”

(I was watching an episode of How Do I Look recently featuring a “normal-weight” anorexic. By the end of the episode nobody was recommending residential or intensive treatment and nobody was suggesting that she consider removing herself from her line of work–she did administrative work for a beauty pageant and was hoping to become a successful pop musician, both of which I would think would be very harmful to an anorexic with these fields’ hyperfocus on appearance and thinness–and far worse, they were reassuring her that she could lose weight, she just had to do it “the healthy way.” It was awful.)

By contrast everybody hates a glutton so it may be easier for a BED sufferer to recognize that what she is doing is “wrong,” especially if she is fat, because she is constantly hearing out in society how wrong it is to overeat and be fat. And there may be more impetus there to get help. I know anorexics fully believe that they are fat and disgusting, so the idea doesn’t completely hold up, but I wonder if societal beliefs and pressures are a factor.

My guess would also be that the death rate from BED and even bulimia is probably lower than that from anorexia, which makes it even trickier to decide when someone’s life and health are at risk and when treatment intervention is needed. I have also heard that BED and bulimia are not as pernicious and resistant to treatment as anorexia, but I don’t know if that is true.

I am not knowledgeable on these issues but these were some impressions and questions that I had.

Spacedcowgirl wrote: “Gemma, I realize these are complicated psychological disorders so no answer can be this trite and simple, but do you think the lack of understanding on the part of anorexics that what they are doing is wrong might have something to do with the fact that restricting/dieting behaviors are condoned by society to some extent?”

Speaking only for myself, yes, I do feel that is part of the issue.

I used to say things like, “well, supermodels are skinnier than me, so why can’t I keep losing weight?”. I had all kinds of external pressures encouraging me to stick to my starvation, and when I looked around, I saw a lot of support for what I was doing. I mean, everyone wants to be thin, right? That’s what I seemed to be told constantly ad nauseum and all I was doing was ‘dieting’ and everyone agrees that dieting is a Good Thing, right? So how could I possibly be doing something wrong?

“So many of us (without a true understanding of the horror experienced by sufferers, of course) have secretly wished at one time or another that we had the “self-control” (ha) required to be anorexic.”

Exactly, because aren’t we forever being preached to that we could be the size we desire if only we had more self control? If only we could just stop stuffing ourselves and instead forced our Rubenesque butts into the gym for 3 hours a day, well, by golly we could be beautiful!

What you mention about the “normal weight” anorexics is so true and so horrible. I looked pretty bad at my worst point but I went to a dance/drama school where most of the students were tiny little ballerinas, so no one was at all concerned by my shrinking body. I was still ‘above average’ in size in such an environment so, surely, nothing could possibly be wrong with me, even if I was down to eating half a breakfast bar and a little clear soup a day, and was constantly dizzy, not to mention manic.

“By contrast everybody hates a glutton so it may be easier for a BED sufferer to recognize that what she is doing is “wrong,” especially if she is fat, because she is constantly hearing out in society how wrong it is to overeat and be fat. And there may be more impetus there to get help.”

I really think you might be on to something here because this makes a lot of sense to me.

Even if anorexics feel and see themselves as hugely obese, they’re not usually treated that way, so I could feasibly see a BED sufferer being more acutely aware of their disease because of societal pressure, whereas an anorexia sufferer might be picking up encouragement from such.

And, on a personal level, recently when I looked at my diet and noticed what seemed to be the beginning of an overeating/compulsive eating disorder, it was much easier for me to recognise this was ‘wrong’ or ‘bad’ because I felt such huge guilt over the fact that I’d gone over my calorie allowance for the day, or had no will power.

Of course, I managed to turn that into something positive but ONLY because I have an excellent support system.

Now that I really think about it, that is such a huge contrast to how I felt when I was anorexic.

Gemma, thank you so much for the response. That is really interesting about how exceeding a calorie allowance tipped you off to a potential binge eating problem. I’m glad that in your case you were able to use that information in a positive way to help yourself rather than harm yourself.

Eating disorders are so complicated and it’s hard to know to what extent, if any, societal factors can exacerbate or affect them.

I think the only ‘lifestyle change’ that should ever be done is …well, I suppose it’s something that fits into the HAES model. Finding activities that work with your body in the size and condition it’s in to make it feel better and improve your muscle tone. NOT to make it smaller – to make it healthier. Eating good, nutritious, fulfilling food – because it makes your body run well, NOT because it will make it smaller. And I don’t think eating that kind of eating means no sweets! It means balance. I think balance is the most important thing in ANY lifestyle/health decision.

I’ll admit, I spent about a year working off some weight I gained because of a medication that disagreed with my body. I’ve kept most of it off for about 2 years now, but at 24 I’m not the size I was at 18 and I’m okay with that.

I’d like to get back into better shape – get my flexibility, strength, endurance, and joint health back where I’d like it to be. In the process, I usually end up losing a size or so, which is nice…but it’s not why I do it. I do it because I feel good when I’m weight lifting 3 days a week, a quick spin on a bike 6 days a week, and yoga a couple times in there too. I like the way my body feels powerful, I like seeing the muscle definition in my legs, arms, and shoulders.

I love my curves. I vary between a size 8 and a size 12. I’m not the size of a model and I wouldn’t want to be. They look like concentration camp survivors. On the other hand, my sister is naturally very slender – I just wish she wouldn’t let that convince her she doesn’t need to eat well and exercise! Yup, my size 2 sister exercises a lot less than size 12 me.

And anyone who wants to give me hell about the fact that I need an XL if I want to wear a buttondown shirt can go to hell! Being a woman is about being comfortable in your body and choosing to wear clothes that fit the size you ARE, not the size you think you should be.

It’s not a bad thing if you start making healthier choices and it causes weight loss. Weight loss needs to stop being the reason for things. As a society, we’re just getting more and more disfunctional about it instead of listening to our bodies.